Role of cardiac bio-markers in monitoring of cardiotoxicity after hematopoietic stem cell transplantation

Advances in hematopoietic stem cell transplantation (HSCT) have increased survival in hematologic diseases. However, HSCT survivors are at risk of developing acute and longterm complications. Cardiac events, such as heart failure, myocardial ischemia and arrhythmias may represent potentially life threatening conditions. Acute cardiotoxicity can occur during the first 100 days after HSCT. Conditioning regimens, including total body irradiation and high dose chemotherapy, previous chemoradiotherapy, including anthracyclines and chest irradiation, are known to be associated with an increased risk of cardiac complications after HSCT. Infectious complications resulting in sepsis due to posttransplant granulocytopenia may also impair myocardial function. Therefore the main strategy for minimizing cardiotoxicity is early detection of high risk patients and prompt prophylactic treatment. Measurement of cardio specific bio-markers can be a valid diagnostic tool for early identification, assessment, and monitoring of cardiotoxicity. In the present article, we review the usefulness of cardiac troponins and natriuretic peptides, the most commonly used bio-markers of myocardial ischemia and ventricular dysfunction, to detect and to predict the development of cardiotoxicity after HSCT.