Clinical outcomes of patients with impaired left ventricular ejection fraction undergoing autologous bone marrow transplantation: can we safely transplant patients with impaired ejection fraction?
Clinical outcomes of patients with impaired left ventricular ejection fraction undergoing autologous bone marrow transplantation: can we safely transplant patients with impaired ejection fraction?
复制标题
左心室射血分数受损患者接受自体骨髓移植的临床结果：我们能否安全地移植射血分数受损患者？
DOI：
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发表时间：
2004
影响因子：
4.8
通讯作者：
B. Bolwell
中科院分区：
文献类型：
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作者：
W. Tang;S. Thomas;M. Kalaycio;R. Sobecks;S. Andresen;J. Jarvis;L. Rybicki;B. Pohlman;G. Francis;B. Bolwell
总结：自体骨髓移植（ABMT）治疗左心室射血分数（LVEF）受损或心力衰竭（HF）患者的经验有限。我们在我院（1996-2003）确定了308例因霍奇金淋巴瘤或非霍奇金淋巴瘤而连续接受ABMT的患者。在保留（小于50%）或受损（小于50%）LVEF的患者之间比较患者特征、临床病程和总生存期。308例患者中，20例基线LVEF受损（4例LVEF≥40%，均为NYHA I-II级HF）。无abmt后超声心动图患者LVEF恶化（n=7）。在20例LVEF受损的患者中，有4例患者在abmt后出现可逆性心脏并发症（包括心衰恶化）。在LVEF受损组中观察到的两例死亡均是由于非心脏原因。LVEF保存和受损患者的5年生存率相似（P=0.43）。谨慎选择稳定、轻度至中度心衰和LVEF受损的患者进行ABMT可以获得类似的长期生存。随着心衰和ABMT的医疗水平的提高，对于心衰和LVEF受损的ABMT的排除标准应该重新检查。
Summary:Experience with autologous bone marrow transplantation (ABMT) in patients with impaired left ventricular ejection fraction (LVEF) or heart failure (HF) is limited. We identified 308 consecutive patients who underwent ABMT for Hodgkin's or non-Hodgkin's lymphoma at our institution (1996–2003). Patient characteristics, clinical course and overall survival were compared between patients with preserved (⩾50%) or impaired (<50%) LVEF. Of the 308 patients identified, 20 had baseline impaired LVEF (four with LVEF ⩽40%, all NYHA class I–II HF). None of the patients with post-ABMT echocardiogram had worsened LVEF (n=7). Among the 20 patients with impaired LVEF, four patients had reversible cardiac complications post-ABMT (including worsening HF). The two deaths observed in the impaired LVEF group were both due to noncardiac causes. The 5-year survival was similar between patients with preserved and impaired LVEF (P=0.43). Careful selection of patients with stable, mild-to-moderate HF and impaired LVEF for ABMT can achieve similar long-term survival. As medical care for HF and ABMT improves, the exclusion criteria for ABMT with regard to HF and impaired LVEF should be re-examined.