Tabriz University of Medical Sciences Journal of Cardiovascular and Thoracic Research 2008-5117 16 4 2024 12 23 Post-transplant cyclophosphamide-induced cardiotoxicity: A comprehensive review 211 221 10.34172/jcvtr.33230 EN Azin Alizadehasl https://orcid.org/0000-0002-8550-1378 Bita Shahrami Reza Rahbarghazi Azam Yalameh Aliabadi Seyedeh Fatemeh Hosseini Jebelli Yasamin Afsari Zonooz Hoda Hakimian Farzaneh Fathi Sara Forati https://orcid.org/0009-0003-6664-6904 Aysa Rezabakhsh https://orcid.org/0000-0003-3942-7848 REVIEW 10.34172/jcvtr.33230 2024 06 17 2024 09 17 Cyclophosphamide-induced cardiotoxicity, associated with its toxic metabolite acrolein, is a significant concern and unresolved issue, especially when cyclophosphamide is administrated in high doses. However, cardiotoxicity following low-dose cyclophosphamide has been also documented, especially in post-hematopoietic stem cell transplantation (post-HSCT) settings. Despite the involvement of multiple signaling pathways in cyclophosphamide-induced cardiomyopathy, the exact underlying mechanisms remain to be fully elucidated. This review outlines the current challenges of cyclophosphamide therapy in HSCT recipients. In addition, the promising therapeutic approaches by targeting acrolein’s anti-angiogenic effect were thoroughly discussed to better manage post-HSCT cyclophosphamide-induced cardiotoxicity.