hematopoietic cell transplantation Incidence and predictors of congestive heart failure following autologous

ABSTRACT Advances in autologous hematopoietic cell transplantation (HCT) strategies have resulted in a growing number of long-term survivors. These survivors are at increased risk of cardiovascular complications due pre-HCT therapeutic exposures, conditioning, and post-HCT comorbidities. We examined the incidence and predictors of congestive heart failure (CHF) in 1244 patients undergoing autologous HCT for a hematologic malignancy between 1988 and 2002. The cumulative incidence (CI) of CHF was 4.8% at 5 years, and increased to 9.1% at 15 years after transplantation; the CI for female lymphoma survivors was 14.5% at 15 years. The cohort was at a 4.5-fold increased risk of CHF (standardized incidence ratio [SIR] = 4.5), when compared with the general population. The risk of CHF increased substantially for patients receiving 250 mg/m 2 of cumulative anthracycline exposure (Odds Ratio [OR]: 9.9, p<0.01), creating a new and lower threshold for cardiac surveillance after HCT. Presence of hypertension among recipients of high-dose (HD) anthracycline ( 250 mg/m