Rotz Seth J, Ryan Thomas D, Hlavaty Joel, George Stephen A, El-Bietar Javier, Dandoy Christopher E
Division of Bone Marrow Transplantation and Immune Deficiency, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Division of Cardiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Pediatr Blood Cancer. 2017 Nov;64(11). doi: 10.1002/pbc.26600. Epub 2017 Apr 28.
Cardiomyopathy is common in long-term survivors of pediatric hematopoietic stem cell transplant (HSCT). Events occurring before and after HSCT when combined with specific insults during HSCT likely contribute to long-term risk. Strategies for detecting subclinical cardiomyopathy prior to patients developing overt heart failure are under investigation. Changes in HSCT preparative regimens and cardioprotective medications administered during chemotherapy may alter the risk for cardiomyopathy. Interventions in long-term survivors such as lifestyle modification and cardioactive medications are of increasing importance. Herein we review the causes of cardiac injury, discuss strategies for detection of cardiomyopathy, and evaluate therapeutic options for long-term HSCT survivors.
心肌病在小儿造血干细胞移植（HSCT）的长期存活者中很常见。HSCT前后发生的事件，再加上HSCT期间的特定损伤，可能会导致长期风险。在患者出现明显心力衰竭之前检测亚临床心肌病的策略正在研究中。HSCT预处理方案的改变以及化疗期间使用的心脏保护药物可能会改变心肌病的风险。对长期存活者的干预措施，如生活方式改变和使用心脏活性药物，正变得越来越重要。在此，我们回顾心脏损伤的原因，讨论心肌病的检测策略，并评估HSCT长期存活者的治疗选择。
