Severe cardiotoxicity following haploidentical stem cell transplantation with posttransplant cyclophosphamide

A 58-year-old male who was diagnosed with myelodysplastic syndrome underwent a haploidentical stem cell transplantation using posttransplant cyclophosphamide. He developed congestive heart failure 2 days after the first administration of cyclophosphamide as the prophylaxis of graft-versus host disease. The patient was urgently intubated and mechanically ventilated. His congestive heart failure gradually improved with conventional supportive care including vasodilator, angiotensin-converting enzyme inhibitor, beta-blocker, and diuretics, and the patient was weaned from the ventilator on day 11. Cyclophosphamide-induced cardiomyopathy is serious complication and should be taken into consideration in haploidentical transplantation with posttransplant cyclophosphamide to enable early recognition of this rare complication and prompt intervention.