Abstract
Sixteen children with hematological disease who had undergone allogeneic stem cell transplantation (SCT) were evaluated to determine the adverse effect of anthracycline (ATC) and cyclophosphamide (CY) used as the conditioning regimen on pre-and post-transplant cardiac function. Methods employed were resting ECG, echocardiography and 123I-BMIPP (beta-methyl-iodophenyl-pentadecanoic acid) imaging. A cumulative ATC dose over 300 mg/m2, especially over 400 mg/m2, was predictable for pre-transplant abnormal findings by parameters such as uptake score (US) and heart mediastinum ratio (H/M). However, the cumulative ATC dose and pre-transplant mild abnormal cardiac findings did not correlate with post-transplant cardiac function. A 200 mg/kg dose of CY was predictable for decreased summated QRS amplitude (QRS sum) and left ventricular mass index (LVMI), however, there was no correlation between the CY dose and the values obtained through BMIPP imaging. Moreover, the CY dose was not a risk factor for worsening post-transplant fractional shortening (FS) as evaluated by echocardiography. In summary, 231I-BMIPP imaging was useful for evaluating subclinical cardiac damage due to ATC before transplant, but not for predicting cardiac damage during the course of SCT.
