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2015 ; 50
(9
): 1212-6
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Arrhythmias in the setting of hematopoietic cell transplants
#MMPMID26030046
Tonorezos ES
; Stillwell EE
; Calloway JJ
; Glew T
; Wessler JD
; Rebolledo BJ
; Pham A
; Steingart RM
; Lazarus H
; Gale RP
; Jakubowski AA
; Schaffer WL
Bone Marrow Transplant
2015[Sep]; 50
(9
): 1212-6
PMID26030046
show ga
Prior studies report that 9-27% of persons receiving a hematopoietic cell
transplant develop arrhythmias, but the effect on outcomes is largely unknown. We
reviewed data from 1177 consecutive patients ?40 years old receiving a
hematopoietic cell transplant at one center during 1999-2009. Transplant
indication was predominately leukemia, lymphoma and multiple myeloma. Overall,
104 patients were found to have clinically significant arrhythmia: 43 before and
61 after transplant. Post-transplant arrhythmias were most frequently atrial
fibrillation (N=30), atrial flutter (N=7) and supraventricular tachycardia
(N=11). Subjects with an arrhythmia post transplant were more likely to have
longer median hospital stays (32 days vs 23, P=<0.001), a greater probability of
an intensive care unit admission (52% vs 7%; P<0.001), greater probability of
in-hospital deaths (28% vs 3%, P<0.001), and greater probability of death within
1 year of transplant (41% vs 15%; P<0.001) compared with patients without
arrhythmia at any time. In a multivariate model including age at transplant,
diagnosis, history of pretransplant arrhythmia, and transplant-related variables,
post-transplant arrhythmia was associated with a greater risk for death within a
year of transplant (odds ratio 3.5, 95% confidence interval: 2.1, 5.9; P<0.001).
Our data suggest that arrhythmias after transplants are associated with
significant morbidity and mortality. A prospective study of arrhythmia in the
transplant setting is warranted.