Role of cardiac bio­markers in monitoring of cardiotoxicity after hematopoietic stem cell transplantation


Authors: Ľ. Roziaková 1,2;  B. Mladosievičová 1
Authors‘ workplace: Oddelenie klinickej patofyziológie Ústavu patologickej fyziológie Lekárskej fakulty UK Bratislava, Slovenská republika, prednosta prof. MU Dr. Marián Bernadič, CSc. 1;  Klinika hematológie a transfuziológie Lekárskej fakulty UK a UN Bratislava, Slovenská republika, prednosta doc. MU Dr. Martin Mistrík, PhD. 2
Published in: Vnitř Lék 2013; 59(11): 996-1002
Category: Review

Overview

Advances in hematopoietic stem cell transplantation (HSCT) have increased survival in hematologic diseases. However, HSCT survivors are at risk of developing acute and long‑term complications. Cardiac events, such as heart failure, myocardial ischemia and arrhythmias may represent potentially life‑ threatening conditions. Acute cardiotoxicity can occur during the first 100 days after HSCT. Conditioning regimens, including total body irradiation and high‑dose chemotherapy, previous chemoradiotherapy, including anthracyclines and chest irradiation, are known to be associated with an increased risk of cardiac complications after HSCT. Infectious complications resulting in sepsis due to post‑transplant granulocytopenia may also impair myocardial function. Therefore the main strategy for minimizing cardiotoxicity is early detection of high‑risk patients and prompt prophylactic treatment. Measurement of cardiospecific bio­markers can be a valid dia­gnostic tool for early identification, assessment, and monitoring of cardiotoxicity. In the present article, we review the usefulness of cardiac troponins and natriuretic peptides, the most commonly used bio­markers of myocardial ischemia and ventricular dysfunction, to detect and to predict the development of cardiotoxicity after HSCT.

Key words:
cardiac bio­markers –  cardiotoxicity –  hematopoietic stem cell transplantation


Sources

1. Bhatia S, Francisco L, Carter A et al. Late mortality after hematopietic stem cell transplantation and functional status of long‑term survivors: report from the Bone Marrow Transplant Survivor Study. Blood 2007; 110: 3784– 3791.

2. Savani BN, Griffith ML, Jagasia S et al. How I treat late effects in adults after allogeneic stem cell transplantation. Blood 2011; 117: 3002– 3009.

3. Sun CL, Francisco L, Kawashima T et al. Prevalence and predictors of chronic health conditions after hematopoietic cell transplantation: a report from the Bone Marrow Transplant Survivor Study. Blood 2010; 116: 3129– 3139.

4. Mo XD, Xu LP, Liu DH et al. Heart failure after allogeneic hematopoietic stem cell transplantation. Int J Cardiol 2013; 167: 2502– 2506.

5. Cardinale D, Sandri MT. Role of bio­markers in chemotherapy‑induced cardiotoxicity. Prog Cardiovasc Dis 2010; 53: 121– 129.

6. Colombo A, Cardinale D. Using cardiac bio­markers and treating cardiotoxicity in cancer. Future Cardiol 2013; 9: 105– 118.

7. Monsuez JJ, Charniot JC, Vignat N et al. Cardiac side‑ effects of cancer chemotherapy. Int J Cardiol 2010; 144: 3– 15.

8. Goncalvesová E, Šimková I, Roziaková Ľ et al. Dia­gnostické možnosti kardiotoxicity protinádorovej liečby. In: Mladosievičová B et al (eds). Kardioonkológia. Bratislava: SAP 2012: 133– 163.

9. Elbl L, Hrstková H, Chaloupka V et al. Dia­gnostic possibilities of late cardiotoxic sequelae of chemotherapy with anthracyclines. Vnitř Lék 2002; 48: 981– 988.

10. Anderson B, Sawyer DB. Predicting and preventing the cardiotoxicity of cancer therapy. Expert Rev Cardiovasc Ther 2008; 6: 1023– 1033.

11. Dolci A, Dominici R, Cardinale D et al. Biochemical markers for prediction of chemotherapy‑induced cardiotoxicity: systematic review of the literature and recommendations for use. Am J Clin Pathol 2008; 130: 688– 695.

12. Sawaya H, Sebag IA, Plana JC et al. Early detection and prediction of cardiotoxicity in chemotherapy‑treated patients. Am J Cardiol 2011; 107: 1375– 1380.

13. Palladini G, Merlini G. Transplantation vs conventional‑dose therapy for amyloidosis. Curr Opin Oncol 2011; 23: 214– 220.

14. Bryant J, Picot J, Baxter L et al. Use of cardiac markers to assess the toxic effects of anthracyclines given to children with cancer: a systematic review. Eur J Cancer 2007; 43: 1959– 1966.

15. Horacek JM, Tichy M, Pudil R et al. Multimarker approach to evaluation of cardiac toxicity during preparative regimen and hematopoietic cell transplantation. Neoplasma 2008; 55: 532– 537.

16. Clerico A, Vittorini S, Passino C et al. New and emerging bio­markers of heart failure. Crit Rev Clin Lab Sci 2009; 46: 107– 128.

17. Vasile VC, Saenger AK, Kroning JM et al. Biological and analytical variability of a novel high‑sensitivity cardiac troponin T assay. Clin Chem 2010; 56: 1086– 1090.

18. Coghlan JG, Handler CE, Kottaridis PD. Cardiac assessment of patients for haematopoietic stem cell transplantation. Best Pract Res Clin Haematol 2007; 20: 247– 263.

19. Špirková Z, Daňová K, Pecháň I et al. Kardiomarkery. Bratislava: Phonec Agency 2005.

20. Clerico A, Carlo Zucchelli G, Pilo A et al. Clinical relevance of bio­logical variation: the les­son of brain natriuretic peptide (BNP) and NT‑ proBNP assay. Clin Chem Lab Med 2006; 44: 366– 378.

21. Bálková O. Mezinárodní panel expertů: stanovení NT‑ proBNP v klinické praxi. Labor Aktuell 2008; 2: 14– 21.

22. McMurray JJ, Adamopoulos S, Anker SD et al. ESC Guidelines for the dia­gnosis and treatment of acute and chronic heart failure 2012. The Task Force for the Dia­gnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Eur Heart J 2012; 33: 1787– 1847.

23. Carver JR, Shapiro CL, Jacobs L et al. American Society of Clinical Oncology clinical evidence review on the ongoing care of adult cancer survivors: cardiac and pulmonary late effects. J Clin Oncol 2007; 25: 3991– 4008.

24. Baggish AL, Van Kimmenade RR, Januzzi JL Jr. The differential dia­gnosis of an elevated amino‑terminal pro‑B‑type natriuretic peptide level. Am J Cardiol 2008; 101: 43– 48.

25. Januzzi JL Jr, Camargo CA, Anwaruddin S et al. The N‑terminal Pro‑BNP investigation of dyspnea in the emergency department (PRIDE) study. Am J Cardiol 2005; 95: 948– 954.

26. Januzzi JL, Van Kimmenade R, Lainchbury J et al. NT‑ proBNP testing for dia­gnosis and short‑term prognosis in acute destabilized heart failure: an international pooled analysis of 1256 patients: the International Collaborative of NT‑ proBNP Study. Eur Heart J 2006; 27: 330– 337.

27. Snowden JA, Hill GR, Hunt P et al. Assess­ment of cardiotoxicity during haemopoietic stem cell transplantation with plasma brain natriuretic peptide. Bone Marrow Transplant 2000; 26: 309– 313.

28. Niwa N, Watanabe E, Hamaguchi M et al. Early and late elevation of plasma atrial and brain natriuretic peptides in patients after bone marrow transplantation. Ann Hematol 2001; 80: 460– 465.

29. Horacek JM, Pudil R, Tichy M et al. Biochemical markers and assessment of cardiotoxicity during preparative regimen and hematopoietic cell transplantation in acute leukemia. Exp Oncol 2007; 29: 343– 347.

30. Masuko M, Ito M, Kurasaki T et al. Plasma brain natriuretic peptide during myeloablative stem cell transplantation. Intern Med 2007; 46: 551– 555.

31. Zver S, Zadnik V, Bunc M et al. Cardiac toxicity of high‑dose cyclophosphamide in patients with multiple myeloma undergoing autologous hematopoietic stem cell transplantation. Int J Hematol 2007; 85: 408– 414.

32. Chung T, Lim WC, Sy R et al. Subacute cardiac toxicity following autologous haematopoietic stem cell transplantation in patients with normal cardiac function. Heart 2008; 94: 911– 918.

33. Roziakova L, Bojtarova E, Mistrik M et al. Serial measurements of cardiac bio­markers in patients after allogeneic hematopoietic stem cell transplantation. J Exp Clin Cancer Res 2012; 31: 13.

34. Sandri MT, Salvatici M, Cardinale D et al. N‑terminal pro‑B‑type natriuretic peptide after high‑dose chemotherapy: a marker predictive of cardiac dysfunction? Clin Chem 2005; 51: 1405– 1410.

35. Xun CQ, Thompson JS, Jennings CD et al. Effect of total body irradiation, busulfan‑ cyclophosphamide, or cyclophosphamide conditioning on inflammatory cytokine release and development of acute and chronic graft‑ versus‑ host disease in H‑ 2– incompatible transplanted SCID mice. Blood 1994; 83: 2360– 2367.

36. Packard RR, Libby P. Inflammation in atherosclerosis: from vascular bio­logy to bio­marker discovery and risk prediction. Clin Chem 2008; 54: 24– 38.

37. Bujak M, Frangogiannis NG. The role of IL‑1 in the pathogenesis of heart disease. Arch Immunol Ther Exp (Warsz) 2009; 57: 165– 176.

38. Roziakova L, Bojtarova E, Mistrik M et al. Abnormal cardiomarkers in leukemia patients treated with allogeneic hematopoietic stem cell transplantation. Bratisl Lek Listy 2012; 113: 159– 162.

39. Roziakova L, Bojtarova E, Mistrik M et al. The role of cardiac bio­markers after allogeneic haematopoietic stem cell transplantation: can we predict cardiac dysfunction? Bone Marrow Transplant 2012; 47 (Supl 1): S191.

40. Peres E, Levine JE, Khaled YA et al. Cardiac complications in patients undergoing a reduced‑ intensity conditioning hematopoietic stem cell transplantation. Bone Marrow Transplant 2010; 45: 149– 151.

41. Roziakova L, Mistrik M, Bojtarova E et al. Biochemical markers for early detection and prediction of cardiotoxicity in patients after hematopoietic stem cell transplantation. Haematologica 2012; 97 (Suppl 1): S412.

42. O’Brien PJ. Cardiac troponin is the most effective translational safety bio­marker for myocardial injury in cardiotoxicity. Toxicology 2008; 245: 206– 218.

43. Cardinale D, Sandri MT, Colombo A et al. Prognostic value of Troponin I in cardiac risk stratification of cancer patients undergoing high‑dose chemotherapy. Circulation 2004; 109: 2749– 2754.

44. Auner HW, Tinchon C, Linkesch W et al. Prolonged monitoring of troponin T for the detection of anthracycline cardiotoxicity in adults with hematological malignancies. Ann Hematol 2003; 82: 218– 221.

45. Adamcová M, Štěrba M, Šimůnek T et al. Myocardial regulatory proteins and heart failure. Eur J Heart Fail 2006; 8: 333– 341.

46. Agewall S, Giannitsis E, Jernberg T et al. Troponin elevations in coronary vs. Non‑ coronary disease. Eur Heart J 2011; 32: 404– 411.

47. Cardinale D, Sandri MT, Martinoni A et al. Left ventricular dysfunction predicted by early troponin l release after high‑dose chemotherapy. J Am Coll Cardiol 2000; 36: 517– 521.

48. Cardinale D, Sandri MT, Martinoni A et al. Myocardial injury revealed by plasma troponin I in breast cancer treated with high‑dose chemotherapy. Ann Oncol 2002; 13: 710– 715.

49. Sandri MT, Cardinale D, Zorzino L et al. Minor increases in plasma troponin I predict decreased left ventricular ejection fraction after high‑dose chemotherapy. Clin Chem 2003; 49: 248– 251.

50. Lipshultz SE, Rifai N, Dalton VM et al. The effect of dexrazoxane on myocardial injury in doxorubicin‑treated children with acute lymphoblastic leukemia. N Engl J Med 2004; 351: 145– 153.

51. Kilickap S, Barista I, Akgul E et al. CTnT can be a useful marker for early detection of anthracycline cardiotoxicity. Ann Oncol 2005; 16: 798– 804.

52. Auner HW, Tinchon C, Brezinschek RI et al. Monitoring of cardiac function by serum cardiac troponin T levels, ventricular repolarisation indices, and echocardiography after conditioning with fractionated total body irradiation and high‑dose cyclophosphamide. Eur J Haematol 2002; 69: 1– 6.

53. Schully R, Lipschultz SE. Cardiovascular toxicity of antitumor drugs: dimensions of the prob­lem in children. In: Minotti G (ed). Cardiotoxicity of non‑cardiovascular drugs. Chichester: Wiley 2010: 97– 126.

54. Bovelli D, Plataniotis G, Roila F. Cardiotoxicity of chemoterapeutic agents and radiotherapy‑related heart disease: ESMO Clinical Practice Guide­lines. Ann Oncol 2010; 21 (Suppl 5): 277– 282.

55. Majhail NS, Rizzo JD, Lee SJ. Recommended screening and preventive practices in long‑term survivors after hematopoietic stem cell trans­plantation. Biol Blood Marrow Transplant 2012; 18: 348– 371.

56. Majhail NS, Rizzo JD Surviving the cure: long term followup of hematopoietic cell transplant recipients. Bone Marrow Transplant 2013; 48: 1145– 1151.

57. Carver JR, Szalda D, Ky B. Asymptomatic cardiac toxicity in long term cardiac survivors: defining the populations and recommendations for surveillance. Semin Oncol 2013; 40: 229– 238.

Labels
Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 11

2013 Issue 11

Most read in this issue

This topic is also in:


Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account