Hematopoietic stem cell transplant (HSCT), also known as a bone marrow transplant (BMT), is a common treatment for many types of cancer. Past research has shown that bone marrow transplants reduce the health of patient’s heart and can lead to a higher risk of developing heart-related complications. We know that doing exercises to strengthen the heart and can improve cardiac health, but we do not know if doing these exercises before a bone marrow transplant will lower the risk of cardiac complications. This research study is being done to learn what effect exercise before BMT has on cardiac health in patients that are getting bone marrow transplants.  More information about this study can be found here. 

Myocarditis is inflammation of the heart muscle. Inflammation of the heart muscle can lead to serious heart effects such weakening of the heart muscle, dangerous rhythms of the heart, or even death. 

The primary aim of this study is to determine if medication, abatacept as compared to placebo is associated with reduction in major adverse cardiac events (MACE) among patients hospitalized with myocarditis due to an immune checkpoint inhibitor (ICI). Abatacept is approved by the United States Food and Drug Administration (FDA) to treat adults with rheumatoid arthritis and children with juvenile rheumatoid arthritis, but the FDA has not yet approved abatacept to treat myocarditis. 

As it progresses into stage IV, cancer spreads via metastasis to other parts of the body. Melanoma is a highly invasive cancer by nature that can spread throughout the body hematologically (through the blood), lymphatically, and transvenously. This tendency to metastasize results in cardiac metastasis in 50% of melanoma cases, yet discovery of said cases rarely occurs antemortem (before mortality). 

This proposal is focused on understanding the rare diagnosis of antemortem cardiac metastatic melanoma. By studying risk factors, modalities of image screening and treatment, and clinical outcomes, we strive to expedite diagnosis of cardiac metastatic melanoma and lower the burden of mortality for future patients. 

We are utilizing a retrospective chart review for patients diagnosed with stage IV melanoma and histologically confirmed findings of cardiac metastasis. From these charts, we will compare and contrast trends related to comorbidities, symptomatology, imaging findings, interventions, and outcomes to understand the associated mortality risk factors and outcomes for cardiac metastatic melanoma.

Hematopoietic stem cell transplantation (HSCT), also known as bone marrow transplantation, is a potentially curative therapy for many life-threatening cancers, non-malignant marrow disorders, and in-borne errors of metabolism. Hematopoietic progenitor cells are collected from a human donor from multiple possible sources (bone marrow, peripheral blood, umbilical cord blood) and administered to the patient to reconstitute their bone marrow after suppression by chemotherapeutic treatments. Over 20,000 bone marrow transplants are performed annually in the United States. 

Unfortunately, patients undergoing HSCT are subjected to challenges to nearly all organ system, including various cardiovascular complications. Early cardiovascular complications include arrhythmias, congestive heart failure, and acute thrombosis. HSCT survivors beyond the first 100 days remain at a higher risk of complications including death from cardiac causes, hypertension, diabetes mellitus, hyperlipidemia, and heart failure at an incidence of 10% at 15 years, a rate that is close to 5-fold higher than the general population, and with the increasing use of HSCT as the field grows, the incidence of cardiovascular complications is only expected to increase.

We aim to establish evidence-based strategies to identify cancer patients undergoing HSCT at high risk of cardiovascular complications and optimize their cardiovascular health prior to, and following, transplantation. 

Find more information on bone marrow transplants and the BMT program at University of Michigan, as well as UM's pediatric program.

Also, find our recent publication on the clinical and research tools used to study cardiovascular effects of cancer therapy.  

The use of chimeric antigen receptor T-cell (CAR-T) therapy has rapidly grown since FDA approval in 2017 of Yescarta for Diffus Large B-cell Lymphoma (DLBCL) and Kymriah for Acute B Lymphoblastic Leukemia (B-ALL). While a promising and lifesaving therapy for patients with refractory hematologic malignancies, CAR-T therapy has a series of unique toxicities that create management challenges. 

The cytokine release syndrome (CRS) and CAR-T related neurotoxicity are well described, however the incidence of therapy related onset of cardiac dysfunction, the risk factors for the onset, and the implications of patients with new dysfunction is still unclear. 

We plan to describe the incidence of CAR-T therapy related cardiac dysfunction, and to  delineate risk factors or protective factors that will help us to guide the use of this therapy and potential treatments for short-term and long-term survivors. 

To learn more about CAR-T therapy, find information on UM's Rogel Cancer Center page, health blog, or news release for children with leukemia.

Find symptoms of cytokine release syndrome here.

Learn more about CAR-T related neurotoxicity in these articles.