Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Associate Professor Jordi Sanchez Dahl, University of Southern Denmark, Denmark
- Second opponent: Professor Mai Tone Lønnebakken, University of Bergen
- Third member and chair of the evaluation committee: Associate Professor Johannes Lagethon Bjørnstad, University of Oslo
Chair of the Defence
Professor Knut Lundin, University of Oslo
Principal Supervisor
Senior Consultant, PhD Jan Otto Beitnes, Oslo University Hospital
Summary
Allogeneic hematopoietic stem-cell transplantation (allo-HSCT) is an increasingly chosen therapy to treat young sufferers for a variety of malignant and non-malignant diseases. However, Allo-HSCT is a highly intensive and toxic therapy that can lead to late-onset complications. Aside from reducing quality of life, these complications can be life threatening. Of special concern is the prospect of heart disease in long-term survivors as a consequence of exposure to high-dose chemotherapies. In spite of this, there is limited knowledge on the prevalence and types of cardiac impairments in long-term survivors of allo-HSCT.
In this PhD thesis, Massey and colleagues present the findings from studies that used comprehensive echocardiography, speckle tracking echocardiography (strain imaging) and cardio-pulmonary exercise tests in long-term survivors treated with allo-HSCT as children, adolescents and young adults. The studies found frequent impairments, which included left and right ventricular dysfunction and pericardial abnormalities. Treatment with anthracyclines and hypertension were the main risk factors associated with ventricular dysfunction. The adverse effects from anthracyclines were observed to be dose-dependent. Furthermore, left ventricular systolic dysfunction was found to be associated with reduced peak oxygen uptake.
Overall, the findings give new and valuable insights into the long-term effects after allo-HSCT. The thesis recommends that young patients treated with allo-HSCT require life-long surveillance. This needs to incorporate assessment of modifiable cardiovascular risk factors and heart function examination with echocardiography and strain imaging. The studies identified several high risk factors that can warrant valid reasons for greater surveillance with echocardiography.
Additional information
Contact the research support staff.