Cardio-oncology & otherCohort study
Postural Orthostatic Tachycardia Syndrome and Orthostatic Hypotension Following Hematopoietic Stem Cell Transplantation
- Prospective cohort study
- single-centre
Authors' conclusion
Approximately 1 in 4 patients developed POTS after HSCT, characterized by exaggerated increases in norepinephrine upon standing and elevated AR-modulating autoantibody activity.
Study context
- Population
- Patients undergoing hematopoietic stem cell transplantation (HSCT); multiple myeloma most common indication (67.4%)
- Participants
- 46 patients
- Exposure
- Autologous HSCT vs Allogeneic HSCT
- Autologous HSCTn = 40
- Allogeneic HSCTn = 6
- Outcome
- Prevalence of POTS and OH before HSCT and incidence of new cases after HSCT (10-minute active stand test)
- Follow-up
- 30 days before and 30 and 100 days after HSCT
Main finding
As reported in the abstract
POTS and OH
- Prevalence of POTS before HSCT
- 4.3%
- Prevalence of orthostatic hypotension (OH) before HSCT
- 4.3%
- POTS at 30 days after HSCT (of 39 patients)
- 10 (25.6%)
- New POTS cases at 30 days
- 9 (23.1%)
- OH at 30 days after HSCT
- 6 (15.4%)
- New OH cases at 30 days
- 5 (12.8%)
Observational data: associations, not effects.
Further findings
Increase in norepinephrine upon standing, patients with POTS at 30 days vs before HSCT
- Median increase at 30 days (Q1-Q3: 179%-343%)
- 231%
- Median increase before HSCT (Q1-Q3: 62%-183%)
- 100%
- 30 days vs before HSCT
- P = 0.005
- Positively correlated with heart rate changes
Adrenergic receptor (AR)-modulating autoantibody activity (8 with POTS, 8 without) · after HSCT
- Higher in patients with POTS vs without; directly correlated with heart rate changes
Original publication
Postural Orthostatic Tachycardia Syndrome and Orthostatic Hypotension Following Hematopoietic Stem Cell Transplantation. JACC CardioOncol. doi:10.1016/j.jaccao.2025.05.002
Summarised from the published abstract; every number is checked against it