Transplantation for chemotherapy-induced cardiomyopathy—case series and review of current practice

Statin Use Can Attenuate the Decline in Left Ventricular Ejection Fraction and the Incidence of Cardiomyopathy in Cardiotoxic Chemotherapy Recipients: A Systematic Review and Meta-Analysis

“…Although cardiac dysfunction related to chemotherapy could be addressed with an interruption or discontinuation of chemotherapy, the cessation of chemotherapy in cancer patients may be related to poor clinical outcomes from the oncology standpoint. Furthermore, 0.5-2.5% of patients with chemotherapy-induced cardiomyopathy may have end-stage heart failure requiring a left-ventricular assist device or even heart transplant [9,10,[33][34][35]. Due to the possible poor trajectory, guidelines for prevention and surveillance of chemotherapy-induced cardiomyopathy are imperative.…”

“…Successful cancer treatments are on the rise, and so cancer survivorship continues to increase. Although chemotherapy has remained as one of the essential cancer treatment measures, various adverse effects have been noted, including chemotherapy-induced cardiotoxicity (CIC), which is characterized by a progressive decline in the left ventricular ejection fraction (LVEF) and subsequent heart failure, either in a reversible, stress-induced fashion [5][6][7] or in an irreversible manner that can be fatal and/or chronic [8][9][10].…”

Management of Advanced Heart Failure in Children with Cancer Therapy-Related Cardiac Dysfunction

“…Families also have to be aware that, when facing end of life issues in these complex patients, the LVAD may have to be turned off to allow the patient to die. Therefore, it is extremely important for the heart failure/transplant team to partner with the patient's oncologist when considering these advanced therapies [36,37].…”

“…Historically, a history of solid organ or blood malignancy within five years would be a contraindication for heart transplant. However, this has evolved into a more individualized risk stratification in collaboration with oncology specialists to best understand optimal time for transplant eligibility [19,33,37,50].…”

“…Overall, patients with CCM can have similar heart transplant graft survival to other cohorts. A comprehensive evaluation of all factors that can impact the immune system including oncologic diagnosis, timing and intensity of previous chemotherapy exposure, radiation exposure, and infection history may be particularly helpful in post-transplant management to minimize risk of infection and malignancy [37].…”