Medical News Observer

Key Points:

• The CARE-BMT risk score is based on registry data from over 3,300 patients to establish a contemporary understanding of cardiovascular risks post-transplant. It reveals a 4.1% incidence of cardiovascular events within 100 days and 13.9% after five years.
• The risk score, a simple points-based system, leverages clinical information to evaluate and stratify patients’ cardiovascular risk levels, enhancing pre-transplant evaluations and patient safety.
• This research resulted in guidelines from the American Health Association for managing heart health in bone marrow transplant patients. These guidelines set new care standards from before the transplant to long-term aftercare, aiming to enhance significantly the survival and well-being of those receiving transplants.

Bone marrow transplants, or hematopoietic stem cell transplantation, have become a critical lifeline, offering potential cures for serious diseases such as leukemias, lymphomas, and immune deficiency disorders. While life-saving, these procedures have significant challenges, particularly affecting the cardiovascular system. 

This impact is of notable concern, significantly, as medical advancements and improved protocols have expanded the availability of these transplants to older patients who are at a higher risk for cardiovascular diseases. Researchers at Michigan Medicine have made significant strides in understanding and managing these risks. They’ve established the contemporary prevalence of cardiovascular complications post-transplant and have introduced a novel predictive tool. 

Cardiovascular Registry in Bone Marrow Transplantation 

This innovation aids in evaluating a patient’s risk for cardiovascular issues post-procedure, enhancing the pre-transplant process and ensuring a broader, more appropriate selection of patients for this critical treatment. The research team developed the Cardiovascular Registry in Bone Marrow Transplantation (CARE-BMT), analyzing over 3,300 patients who underwent transplants between 2008 and 2019. 

CARE-BMT risk score

Their findings, which highlighted a 4.1% incidence of cardiovascular events within 100 days and 13.9% after five years, led to the creation of the CARE-BMT risk score. This simple, points-based system utilizes readily accessible clinical information to assess risk levels, effectively identifying patients at high risk for cardiovascular complications. The risk score performed well in different patient groups, including those who had allogeneic or autologous transplants. It has also been validated in separate groups.

Implications

This work culminates in a scientific statement by the American Health Association aimed at guiding the cardiovascular management of patients throughout the bone marrow transplant process, from pre-transplant evaluation to long-term survivorship. Thus, the statement promises to improve patient outcomes and quality of life post-transplant significantly.

References

• Vasbinder, Alexi, Tonimarie Catalan, Elizabeth Anderson, Catherine Chu, Megan Kotzin, Danielle Murphy, Halle Cheplowitz, et al. “Cardiovascular Risk Stratification of Patients Undergoing Hematopoietic Stem Cell Transplantation: The CARE‐BMT Risk Score.” Journal of the American Heart Association 13, no. 1 (January 2, 2024): e033599. https://doi.org/10.1161/JAHA.123.033599.
• Hayek, Salim S., Vlad G. Zaha, Carmel Bogle, Anita Deswal, Amelia Langston, Seth Rotz, Alexi Vasbinder, Eric Yang, Tochukwu Okwuosa, and null null. “Cardiovascular Management of Patients Undergoing Hematopoietic Stem Cell Transplantation: From Pretransplantation to Survivorship. A Scientific Statement From the American Heart Association.” Circulation 0, no. 0. Accessed March 18, 2024. https://doi.org/10.1161/CIR.0000000000001220.
• Vasbinder, Alexi, Christopher W. Hoeger, Tonimarie Catalan, Elizabeth Anderson, Catherine Chu, Megan Kotzin, Jeffrey Xie, et al. “Cardiovascular Events After Hematopoietic Stem Cell Transplant.” JACC: CardioOncology 5, no. 6 (December 2023): 821–32. https://doi.org/10.1016/j.jaccao.2023.07.007
• American Heart Association professional heart daily link https://professional.heart.org/en/science-news/cardiovascular-management-of-patients-undergoing-hematopoietic-stem-cell-transplantation