Grading of cardiac toxicities after allo-HCT
| Cardiac toxicity . | Grade 1 . | Grade 2 . | Grade 3 . | Grade 4 . | Grade 5 . |
|---|---|---|---|---|---|
| Arrhythmia (including atrial fibrillation, atrial flutter, supraventricular tachycardia, ventricular arrhythmia) | Asymptomatic; intervention not indicated | Nonurgent medical intervention indicated | Symptomatic and incompletely controlled medically, or controlled with device, or ablation | Life-threatening consequences; urgent intervention indicated | Death |
| Heart failure (including left ventricular systolic dysfunction) | Asymptomatic with laboratory or cardiac imaging abnormalities | Symptoms with mild to moderate activity or exertion | Severe with symptoms at rest or with minimal activity or exertion; intervention indicated | Life-threatening consequences; urgent intervention indicated | Death |
| — | — | Symptomatic due to drop in ejection fraction (EF) responsive to intervention | Refractory or poorly controlled heart failure due to drop in EF; intervention such as ventricular assist device, IV vasopressor support, or heart transplant indicated | Death | |
| Myocardial infarction or ischemia (including acute coronary syndrome) | — | Asymptomatic and cardiac enzymes minimally abnormal and no evidence of ischemic electrocardiogram (ECG) changes | Severe symptoms; cardiac enzymes abnormal; hemodynamically stable; ECG changes consistent with infarction | Life-threatening consequences; hemodynamically unstable | Death |
| — | Symptomatic, progressive angina; cardiac enzymes normal; hemodynamically stable | Symptomatic, unstable angina and/or acute myocardial infarction, cardiac enzymes abnormal, hemodynamically stable | Symptomatic, unstable angina and/or acute myocardial infarction, cardiac enzymes abnormal, hemodynamically unstable | Death | |
| Pericardial effusion (including pericardial tamponade) | — | Asymptomatic effusion size small to moderate | Effusion with physiologic consequences | Life-threatening consequences; urgent intervention indicated | Death |
| Pericarditis | Asymptomatic, ECG or physical findings consistent with pericarditis | Symptomatic pericarditis | Pericarditis with physiologic consequences | Life-threatening consequences; urgent intervention indicated | Death |
| Cardiac toxicity . | Grade 1 . | Grade 2 . | Grade 3 . | Grade 4 . | Grade 5 . |
|---|---|---|---|---|---|
| Arrhythmia (including atrial fibrillation, atrial flutter, supraventricular tachycardia, ventricular arrhythmia) | Asymptomatic; intervention not indicated | Nonurgent medical intervention indicated | Symptomatic and incompletely controlled medically, or controlled with device, or ablation | Life-threatening consequences; urgent intervention indicated | Death |
| Heart failure (including left ventricular systolic dysfunction) | Asymptomatic with laboratory or cardiac imaging abnormalities | Symptoms with mild to moderate activity or exertion | Severe with symptoms at rest or with minimal activity or exertion; intervention indicated | Life-threatening consequences; urgent intervention indicated | Death |
| — | — | Symptomatic due to drop in ejection fraction (EF) responsive to intervention | Refractory or poorly controlled heart failure due to drop in EF; intervention such as ventricular assist device, IV vasopressor support, or heart transplant indicated | Death | |
| Myocardial infarction or ischemia (including acute coronary syndrome) | — | Asymptomatic and cardiac enzymes minimally abnormal and no evidence of ischemic electrocardiogram (ECG) changes | Severe symptoms; cardiac enzymes abnormal; hemodynamically stable; ECG changes consistent with infarction | Life-threatening consequences; hemodynamically unstable | Death |
| — | Symptomatic, progressive angina; cardiac enzymes normal; hemodynamically stable | Symptomatic, unstable angina and/or acute myocardial infarction, cardiac enzymes abnormal, hemodynamically stable | Symptomatic, unstable angina and/or acute myocardial infarction, cardiac enzymes abnormal, hemodynamically unstable | Death | |
| Pericardial effusion (including pericardial tamponade) | — | Asymptomatic effusion size small to moderate | Effusion with physiologic consequences | Life-threatening consequences; urgent intervention indicated | Death |
| Pericarditis | Asymptomatic, ECG or physical findings consistent with pericarditis | Symptomatic pericarditis | Pericarditis with physiologic consequences | Life-threatening consequences; urgent intervention indicated | Death |
Adapted from Common Terminology Criteria for Adverse Events, version 4.0.14