Baseline characteristics of the study cohort and according to early cardiac toxicity
| Baseline characteristics . | All patients N = 1020 . | Patients with ECEs n = 49 . | No ECEs n = 971 . | P value . |
|---|---|---|---|---|
| Age, y, median (range) | 55 (44-62) | 60 (48-66) | 54 (44-62) | .003 |
| >59 | 369 (36.2) | 26 (53.1) | 343 (34.3) | .012 |
| Sex | ||||
| Male | 530 (52.7) | 29 (59.2) | 509 (52.4) | .355 |
| Female | 482 (47.3) | 20 (40.8) | 462 (47.6) | |
| Relevant comorbidities | ||||
| Active smoker | 111 (10.9) | 12 (24.5) | 105 (10.8) | .754 |
| HTN | 195 (19.1) | 19 (38.8) | 177 (18.2) | <.001 |
| DLP | 133 (13.1) | 15 (30.8) | 111 (12.2) | <.001 |
| Diabetes mellitus | 74 (7.2) | 4 (8.2) | 70 (7.2) | .810 |
| Obesity (BMI ≥30) | 70 (6.9) | 1 (2.0) | 69 (7.1) | .166 |
| History of cardiac disease | 131 (12.8) | 10 (20.4) | 121 (12.4) | .122 |
| Arrhythmia | 36 (3.5) | 4 (8.2) | 32 (3.2) | |
| Heart failure | 18 (1.7) | 2 (4.0) | 16 (1.6) | |
| Myocardial ischemia | 16 (1.5) | 1 (2.0) | 15 (1.5) | |
| Pericardial disorders∗ | 9 (0.9) | 2 (4.0) | 7 (0.7) | |
| Valvopathy | 33 (3.2) | 1 (2.0) | 32 (3.2) | |
| Other | 7 (0.6) | 0 | 7 (0.7) | |
| Abnormalities on ECHO or ECG before allo-HCT† | 12 (1.2) | 0 | 12 (1.2) | |
| Prior treatment with cardiotoxic chemotherapy | 31 (3.0) | 1 (2.0) | 30 (3.1) | 1 |
| Disease status before allo-HCT | ||||
| Complete remission | 923 (90.4) | 42 (85.7) | 888 (90.7) | .243 |
| Refractory AML/active disease | 97 (9.5) | 7 (14.3) | 90 (9.3) | |
| HCT-CI | ||||
| >3 | 142 (14.9) | 10 (20.8) | 132 (14.5) | .234 |
| Missing | 64 | 1 | 63 | |
| Main allo-HCT information | ||||
| Intensity | ||||
| Myeloablative | 594 (58.2) | 23 (46.9) | 571 (58.8) | .1 |
| Reduced intensity | 426 (41.8) | 25 (53.1) | 400 (41.2) | |
| MAC regimen containing CY | 140 (13.7) | 4 (8.2) | 136 (14.4) | .294 |
| TBI | ||||
| High dose TBI (12 Gy) | 45 (4.4) | 1 (2.0) | 44 (4.5) | .719 |
| GVHD prophylaxis | ||||
| PTCY-based | 461 (45.2) | 35 (71.1) | 426 (43.9) | <.001 |
| Others | 559 (54.8) | 14 (28.6) | 545 (56.1) | |
| Donor | ||||
| 10/10 MSD | 362 (35.3) | 13 (26.5) | 349 (35.9) | <.001 |
| 10/10 MUD | 299 (29.3) | 13 (26.5) | 286 (29.5) | |
| 9/10 MMUD | 86 (8.4) | 0 | 86 (8.9) | |
| Haploidentical | 273 (26.8) | 23 (46.9) | 250 (25.7) | |
| Main results | ||||
| Median days to neutrophil engraftment | 17 (15-19) | 16 (14-18) | 17 (15-19) | .325 |
| Median days to platelet engraftment | 15 (12-24) | 16 (13-26) | 15 (12-24) | .416 |
| Graft failure | 36 (3.6) | 1 (2.0) | 35 (3.7) | .231 |
| Missing data | 18 | 3 | 15 | |
| Cumulative incidence of GVHD | ||||
| Day +100 grade 2-4 aGVHD | 33.5 (30.6-36.5) | 34.7 (21.7-48.1) | 33.5 (30.5-36.5) | .513 |
| Day +100 grade 3-4 aGVHD | 9.3 (7.6-11.2) | 8.2 (2.6-18.0) | 9.3 (7.6-11.3) | .545 |
| Baseline characteristics . | All patients N = 1020 . | Patients with ECEs n = 49 . | No ECEs n = 971 . | P value . |
|---|---|---|---|---|
| Age, y, median (range) | 55 (44-62) | 60 (48-66) | 54 (44-62) | .003 |
| >59 | 369 (36.2) | 26 (53.1) | 343 (34.3) | .012 |
| Sex | ||||
| Male | 530 (52.7) | 29 (59.2) | 509 (52.4) | .355 |
| Female | 482 (47.3) | 20 (40.8) | 462 (47.6) | |
| Relevant comorbidities | ||||
| Active smoker | 111 (10.9) | 12 (24.5) | 105 (10.8) | .754 |
| HTN | 195 (19.1) | 19 (38.8) | 177 (18.2) | <.001 |
| DLP | 133 (13.1) | 15 (30.8) | 111 (12.2) | <.001 |
| Diabetes mellitus | 74 (7.2) | 4 (8.2) | 70 (7.2) | .810 |
| Obesity (BMI ≥30) | 70 (6.9) | 1 (2.0) | 69 (7.1) | .166 |
| History of cardiac disease | 131 (12.8) | 10 (20.4) | 121 (12.4) | .122 |
| Arrhythmia | 36 (3.5) | 4 (8.2) | 32 (3.2) | |
| Heart failure | 18 (1.7) | 2 (4.0) | 16 (1.6) | |
| Myocardial ischemia | 16 (1.5) | 1 (2.0) | 15 (1.5) | |
| Pericardial disorders∗ | 9 (0.9) | 2 (4.0) | 7 (0.7) | |
| Valvopathy | 33 (3.2) | 1 (2.0) | 32 (3.2) | |
| Other | 7 (0.6) | 0 | 7 (0.7) | |
| Abnormalities on ECHO or ECG before allo-HCT† | 12 (1.2) | 0 | 12 (1.2) | |
| Prior treatment with cardiotoxic chemotherapy | 31 (3.0) | 1 (2.0) | 30 (3.1) | 1 |
| Disease status before allo-HCT | ||||
| Complete remission | 923 (90.4) | 42 (85.7) | 888 (90.7) | .243 |
| Refractory AML/active disease | 97 (9.5) | 7 (14.3) | 90 (9.3) | |
| HCT-CI | ||||
| >3 | 142 (14.9) | 10 (20.8) | 132 (14.5) | .234 |
| Missing | 64 | 1 | 63 | |
| Main allo-HCT information | ||||
| Intensity | ||||
| Myeloablative | 594 (58.2) | 23 (46.9) | 571 (58.8) | .1 |
| Reduced intensity | 426 (41.8) | 25 (53.1) | 400 (41.2) | |
| MAC regimen containing CY | 140 (13.7) | 4 (8.2) | 136 (14.4) | .294 |
| TBI | ||||
| High dose TBI (12 Gy) | 45 (4.4) | 1 (2.0) | 44 (4.5) | .719 |
| GVHD prophylaxis | ||||
| PTCY-based | 461 (45.2) | 35 (71.1) | 426 (43.9) | <.001 |
| Others | 559 (54.8) | 14 (28.6) | 545 (56.1) | |
| Donor | ||||
| 10/10 MSD | 362 (35.3) | 13 (26.5) | 349 (35.9) | <.001 |
| 10/10 MUD | 299 (29.3) | 13 (26.5) | 286 (29.5) | |
| 9/10 MMUD | 86 (8.4) | 0 | 86 (8.9) | |
| Haploidentical | 273 (26.8) | 23 (46.9) | 250 (25.7) | |
| Main results | ||||
| Median days to neutrophil engraftment | 17 (15-19) | 16 (14-18) | 17 (15-19) | .325 |
| Median days to platelet engraftment | 15 (12-24) | 16 (13-26) | 15 (12-24) | .416 |
| Graft failure | 36 (3.6) | 1 (2.0) | 35 (3.7) | .231 |
| Missing data | 18 | 3 | 15 | |
| Cumulative incidence of GVHD | ||||
| Day +100 grade 2-4 aGVHD | 33.5 (30.6-36.5) | 34.7 (21.7-48.1) | 33.5 (30.5-36.5) | .513 |
| Day +100 grade 3-4 aGVHD | 9.3 (7.6-11.2) | 8.2 (2.6-18.0) | 9.3 (7.6-11.3) | .545 |
| Relapse | 298 (29.3) | 13 (26.5) | 286 (29.5) | 0.651 |
| Dead | 414 (40.5) | 27 (55.1) | 387 (39.9) | 0.034 |
| Directly secondary to ECE | 4 (0.4) | 4 (8.1) | 0 |
| Relapse | 298 (29.3) | 13 (26.5) | 286 (29.5) | 0.651 |
| Dead | 414 (40.5) | 27 (55.1) | 387 (39.9) | 0.034 |
| Directly secondary to ECE | 4 (0.4) | 4 (8.1) | 0 |
BMI, body mass index; ECG, electrocardiogram; ECHO, echocardiography; HCT-CI, HCT–comorbidity index; TBI, total body irradiation; MSD, matched sibling donor; MUD, matched unrelated donor; MMUD, mismatched unrelated donor.
Pericarditis or moderate/severe pericardial effusion.
Patients without cardiac history but with relevant abnormalities diagnosed in the ECHO or ECG and LVEF of <45% and without a history of cardiac disorders.