Bone marrow suppression and associated consequences in patients after heart transplantation: A 6-year retrospective review

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00023001%3A_____%2F15%3A00059547" target="_blank" >RIV/00023001:_____/15:00059547 - isvavai.cz</a>

Result on the web

<a href="http://biomed.papers.upol.cz/pdfs/bio/2015/03/06.pdf" target="_blank" >http://biomed.papers.upol.cz/pdfs/bio/2015/03/06.pdf</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.5507/bp.2015.022" target="_blank" >10.5507/bp.2015.022</a>

Result language

angličtina

Original language name

Bone marrow suppression and associated consequences in patients after heart transplantation: A 6-year retrospective review

Original language description

Aims. To evaluate the incidence of bone marrow suppression and consequences of MMF dose adjustment in patients within the first year after heart transplantation. Methods. Group I (n=47) was treated with a regimen currently used in patients after heart transplantation (mycophenolatemofetil - MMF, valganciclovir - VGC and trimethoprim/sulfamethoxazole - TMP-SMX). Group II (n=47) received only MMF of potentially myelotoxic medications. The myelotoxic effect and need for dose modification were assessed. The incidence of rejections and infectious episodes associated with MMF adjustment were analyzed during the first 12 months in Group I. Results. There was a significantly greater proportion of patients with leukopenia (leukocyte count < 4 x 10<^>9/L) at 3 months after orthotopic heart transplantation in Group I compared with Group II (19.1% vs 2.1%; P=0.02). The difference in lymphopenia (lymphocyte count < 0.8 x 10<^>9/L) at 3 months follow-up was highly significant (38.3 % vs 6.4 %; P=0.0002). MMF was modified due to bone marrow suppression or severe infection in 63.8% patients in Group I and in only 8.5% of patients in Group II (P < 0.001). Reducing or stopping MMF was not associated with increased rejections. In Group I, at least 1 episode of higher degree cellular or humoral rejection occurred in 35% of patients with the standard MMF dosage compared with only 26% in patients with modified MMF (P=0.0534). Conclusions. Addition of VGC+TMP-SMX to current immunosuppressive medication regimen in patients after heart transplantation is associated with significant lymphocytopenia and leukopenia. Importantly, modification of immunosuppressive prophylaxis (reducing or stopping MMF) leads to normalization of blood count without increased incidence of rejections.

Czech name

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Czech description

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Type

J_x - Unclassified - Peer-reviewed scientific article (Jimp, Jsc and Jost)

CEP classification

FA - Cardiovascular diseases including cardio-surgery

OECD FORD branch

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Project

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Continuities

N - Vyzkumna aktivita podporovana z neverejnych zdroju

Publication year

2015

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Biomedical papers

ISSN

1213-8118

e-ISSN

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Volume of the periodical

159

Issue of the periodical within the volume

3

Country of publishing house

CZ - CZECH REPUBLIC

Number of pages

6

Pages from-to

372-377

UT code for WoS article

000364948100006

EID of the result in the Scopus database

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