Pre-HSCT Cardiovascular Evaluation

Curing multiple hematologic malignancies and occasionally non-malignant and benign conditions in a potential manner, the procedure of hematopoietic stem cell transplantation (HSCT)Hematopoietic Stem Cell Transplantation (HSCT) poses a significant threat to morbidity and mortality. An extensive pretransplantPretransplant workup, aimed at minimizing risks, is part of the efforts to make transplantation safer. This includes the optimal selection of transplant candidates. HSCT offers a potential cure for multiple and different hematologic malignancies and, in rare cases, non-malignant conditions. However, it is important to note that this procedure carries a considerable risk of morbidity and mortality. An extensive pretransplantPretransplant workup and optimal selection of transplant candidates comprise attempts to improve the safety of the procedure. Prior research has demonstrated an association between pre-transplant abnormalities and transplant outcomes. The assessment of individual parameters, such as pulmonary function tests (PFTs), findings in echocardiographyEchocardiography tests, and the evaluation of the Charlson Comorbidity Index (CCI), like the Hematopoietic cell transplantation—specific comorbidity index (HCT-CI), are part of this process. These studies reveal correlations between pretransplantPretransplant health status and eventual transplant success. Cardiac complicationsCardiac complications including heart failureHeart failure, pulmonary edema, sudden cardiac death, arrhythmia, and pericarditis arising in the first 100 days following HSCTHematopoietic Stem Cell Transplantation (HSCT) are categorized as acute cardiotoxicityCardiotoxicity related to the procedure. Prior anthracyclineAnthracyclines treatment is an established predisposing factor for cardiotoxicity. Notably, diminished cardiac systolic and diastolic function can present few months to years after initial anthracycline exposure. Consequently, comprehensive cardiac evaluation is imperative for all patients undergoing HSCT. This chapter will examine recommended assessments of cardiac status in HSCTHematopoietic Stem Cell Transplantation (HSCT) candidates with a history of anthracyclineAnthracyclines therapy.