{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T21:18:35Z","timestamp":1790543915349,"version":"4.1.0"},"reference-count":35,"publisher":"American Society of Clinical Oncology (ASCO)","issue":"34","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCO"],"published-print":{"date-parts":[[2008,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To examine the independent roles of pre\u2013hematopoietic cell transplantation (HCT) therapeutic exposures, transplantation-related conditioning, and comorbidities (pre- and post-HCT) in the development of late congestive heart failure (CHF) after HCT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a nested case-control design. Individuals with late CHF (diagnosed \u2265 1 year after HCT) were identified from a cohort of 2,938 1+ year survivors who underwent transplantation at City of Hope National Medical Center, Duarte, CA. This cohort formed the sampling frame for selecting controls (without CHF) matched for age and year of HCT, donor source (allogeneic v autologous), and length of follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty patients with late CHF were identified; median age at HCT was 45.3 years (range, 16.6 to 68.6 years); median time to CHF was 3.0 years (range, 1.03 to 18.9 years); 68% received autologous HCT. Median ejection fraction was 36.9% (range, 15% to 53%). Compared with matched controls (n = 166), patients with late CHF received more cycles of pre-HCT chemotherapy (8.6 v 4.9 cycles; P &lt; .01), had greater body mass index at HCT (28.4 v 26.2 kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; P = .01), greater lifetime anthracycline exposure (285.3 v 175.6 mg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ; P &lt; .01), and were more likely to have multiple chronic comorbidities (30.0% v 13.9%; P &lt; .01). Multivariable analysis revealed number of pre-HCT chemotherapy cycles (odds ratio [OR] = 1.2; P &lt; .01), anthracycline dose \u2265 250 mg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (OR = 3.2; P = .05), and two or more chronic comorbidities (OR = 4.3; P = .01) to be independently associated with late CHF.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pre-HCT exposure to anthracyclines and presence of comorbidities are primarily responsible for the risk associated with late CHF after HCT. Conditioning-related therapeutic exposure does not contribute significantly to the risk. These results form the basis for identifying high-risk individuals for targeted surveillance, as well as developing preventive strategies in the form of aggressive management of comorbidities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1200\/jco.2008.17.7428","type":"journal-article","created":{"date-parts":[[2008,9,22]],"date-time":"2008-09-22T20:14:30Z","timestamp":1222114470000},"page":"5537-5543","source":"Crossref","is-referenced-by-count":133,"title":["Late Congestive Heart Failure After Hematopoietic Cell Transplantation"],"prefix":"10.1200","volume":"26","author":[{"given":"Saro H.","family":"Armenian","sequence":"first","affiliation":[{"name":"From the Division of Hematology\/Oncology, Childrens Hospital Los Angeles; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles; Divisions of Population Sciences and Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA; and the Division of Pediatric Cardiology, University of Minnesota, Minneapolis, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can-Lan","family":"Sun","sequence":"additional","affiliation":[{"name":"From the Division of Hematology\/Oncology, Childrens Hospital Los Angeles; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles; Divisions of Population Sciences and Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA; and the Division of Pediatric Cardiology, University of Minnesota, Minneapolis, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liton","family":"Francisco","sequence":"additional","affiliation":[{"name":"From the Division of Hematology\/Oncology, Childrens Hospital Los Angeles; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles; Divisions of Population Sciences and Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA; and the Division of Pediatric Cardiology, University of Minnesota, Minneapolis, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Steinberger","sequence":"additional","affiliation":[{"name":"From the Division of Hematology\/Oncology, Childrens Hospital Los Angeles; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles; Divisions of Population Sciences and Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA; and the Division of Pediatric Cardiology, University of Minnesota, Minneapolis, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seira","family":"Kurian","sequence":"additional","affiliation":[{"name":"From the Division of Hematology\/Oncology, Childrens Hospital Los Angeles; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles; Divisions of Population Sciences and Hematology and Hematopoietic Cell Transplantation, City of Hope National Medical Center, Duarte, CA; and the Division of Pediatric Cardiology, University of Minnesota, Minneapolis, MN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F. 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