Assessment of cardiotoxicity during haemopoietic stem cell transplantation with plasma brain natriuretic peptide

Snowden, JA, Hill, GR, Hunt, P, Carnoutsos, S, Spearing, RL, Espiner, E and Hart, DNJ (2000) Assessment of cardiotoxicity during haemopoietic stem cell transplantation with plasma brain natriuretic peptide. Bone Marrow Transplantation, 26 3: 309-313. doi:10.1038/sj.bmt.1702507

Author Snowden, JA
Hill, GR
Hunt, P
Carnoutsos, S
Spearing, RL
Espiner, E
Hart, DNJ
Title Assessment of cardiotoxicity during haemopoietic stem cell transplantation with plasma brain natriuretic peptide
Journal name Bone Marrow Transplantation   Check publisher's open access policy
ISSN 0268-3369
Publication date 2000
Sub-type Article (original research)
DOI 10.1038/sj.bmt.1702507
Volume 26
Issue 3
Start page 309
End page 313
Total pages 5
Place of publication Basingstoke, UK
Publisher Macmillan Publishers Ltd
Collection year 2000
Language eng
Subject C1
320200 Immunology
730102 Immune system and allergy
Abstract Cardiac failure is a known complication of haemopoietic stem cell transplantation (HSCT) and is often difficult to diagnose as patients may have multiple medical problems. Since brain natriuretic peptide (BNP) is largely a hormone of cardiac ventricular origin and is released early in the course of ventricular dysfunction, we have examined the value of serial plasma BNP levels for detecting cardiac failure in patients undergoing cytotoxic conditioning for HSCT. Fifteen patients undergoing HSCT were evaluated (10 undergoing autologous HSCT; five undergoing allogeneic HSCT). BNP was measured by radioimmunoassay prior to therapy and weekly for 5 weeks. Seven patients had a significant rise in BNP level (above a previously established threshold of 43 pmol/l associated with cardiac failure), occurring 1-4 weeks post commencement of conditioning. In three of these patients, cardiac failure was subsequently diagnosed clinically 3, 9 and 23 days after a BNP level of 43 pmol/l had been detected. These three patients had the highest peak BNP levels for the group and in each case elevation in BNP level occurred for a period exceeding 1 week. Although numbers were relatively small, a BNP >43 pmol/l was significantly associated with the inclusion of high-dose cyclophosphamide in the preparative regimen (P = 0.02). BNP levels showed no relationship to febrile episodes. In conclusion, these results show that plasma BNP may be used as a marker for early detection of cardiac dysfunction in patients undergoing HSCT, particularly if levels are increased for periods exceeding 1 week. Measurement of BNP during HSCT may be helpful in patients at risk of cardiac failure, in complex clinical situations and in monitoring the cardiotoxicity of preparative regimens.
Keyword Oncology
Bone Marrow Transplantation
Stem Cell Transplantation
Brain Natriuretic Peptide
Cardiac Failure
Bone-marrow Transplantation
High-dose Cyclophosphamide
Acute Myocardial-infarction
Left-ventricular Function
Total-body Irradiation
Cardiac Involvement
Q-Index Code C1

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Citation counts: TR Web of Science Citation Count  Cited 41 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 10 Jun 2008, 13:10:59 EST