الفهرس 
LYMPHOPROLIIFERATIIVE DIISORDERSOnly 14 pages are availabe for public view
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Abstract
Hematopoietic cell transplantation is a widely accepted therapeutic option for hematologic malignancies. Advances in transplantation strategies and supportive care have contributed to the marked improvement in outcome.
The development of cardiovascular disease is one of the most serious complications after haematopoietic cell transplantation. The reported prevalence of left ventricular systolic dysfunction, including symptomatic heart failure and asymptomatic LVSD in adult lymphoma survivors treated with hematopoietic stem-cell transplantation or conventional lymphoma therapy varies between studies, partly because of differences in methodology, cardiotoxic exposure, and observation time.
To our knowledge the impact of Hematopoietic stem cell transplantation on cardiac function of Egyptian patients with Lymphoproliferative disorders has never been studied before. So our study aims at evaluating the effect of HSCT on cardiac functions using non-invasive procedures as well as comparing its impact to that of classic chemotherapy regimens used without transplantation in a group of patients who failed to meet criteria of transplant or refused the procedure.
During echocardiography ejection fraction (EF) was calculated by M-mode and modified Simpson′s formula. Intra-observer variability was reduced by taking the mean of three readings during each echocardiography.
Despite the relatively small sample size and small number of cases included in the study, yet the mean ejection fraction of group I (cases) that received transplant is highly statistically significant less than group II (the negative control group) that included participants without known cardiovascular disease, hypertension, or diabetes mellitus.
Age, sex and surface area showed highly statistical significance. The most lymphoproliferative disorder affected as regard decline in cardiac function was the non-Hodgkin lymphoma that had received the highest doses of Adriamycin prior to transplant to achieve remission.
As regard the conditioning regimens used in the transplant procedure, high dose cyclophosphamide showed to be the most cardiotoxic, this is in accordance with most studies. The use of total body irradiation in the conditioning regimen was also significant.
In conclusion, our results show that group I (the transplant cases) had higher initial ejection fractions compared to group III (the positive control) with highly statistically significant difference by using unpaired t-test (P value <0.001). That can be attributed to the selection process for transplant candidates that generally have better status performance than rejected cases. However, on comparing group I (cases) and group III (positive controls) as regard the significant decline in ejection fraction following definite therapy there was no statistically significant difference between both studied groups.
Also, the transplantation procedure wither auto-transplant or allotransplant within itself doesn’t cause major cardiac affection compared with prolonged use of cytoreductive agents provided proper choice of conditioning regimen thus early transplant can actually be safer.