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Cardiotoxicity in Adult Patients with Relapsed or Refractory Acute Myeloid Leukemia

Fecha de publicación: Fecha Ahead of Print:

Autores de IIS La Fe

Participantes ajenos a IIS La Fe

  • Hillebrand, P
  • Mendizábal, Y
  • Gil, C
  • Botella, C
  • Algarra, L
  • Bermon, JS
  • Boyero, RG
  • Sayas, MJ
  • Tormo, M
  • Lopez, A
  • Valero-Nuñez, M
  • Calabuig, M

Grupos

Abstract

Background/Objectives: The incidence of cardiac morbimortality in patients with relapsed/refractory (R/R) acute myeloid leukemia (AML) is unknown. Methods: We analyze the characteristics, incidence, risk factors, and outcomes of cardiac events in AML patients treated for second-line (2L) or third-line (3L) episodes. Results: Among 327 2L AML patients (median age 62 years old), 135 experienced cardiac events, with an incidence of 38.6% non-fatal and 1.3% fatal events at 6 months. The grade 1-2 incidence was 16.8%, and the grade 3-4 incidence was 23.5% at 6 months. Overall, 207 cardiac events occurred in the 2L cohort, the most frequent being hypertension (n = 45), bradycardia (n = 39), QTc prolongation (n = 35), heart failure (n = 33), syncope/presyncope (n = 22), arrhythmia (n = 18), and myocardial ischemia (n = 8). Median OS in the 2L cohort was 9.4 months, 21.4 months in patients with grade 1-2, 8.8 months in patients without a cardiac event, 7.6 months in grade 3-4 patients, and 2.1 months with in 5 patients (p = 0.0035). The multivariate analysis showed prior cardiologic antecedents (p = 0.013), intensive 2L chemotherapy (p = 0.01), and inclusion in a 2L clinical trial (p < 0.001) as independent risk factors for non-fatal cardiac events. Among 189 patients of the 3L cohort, the incidence of non-fatal and fatal cardiac events was 49.2% and 0% at 6 months, respectively. Non-fatal cardiac events were more frequent in patients with prior cardiac antecedents (p = 0.004). Conclusions: In summary, cardiotoxicity is a frequent and challenging complication in R/R AML patients. We identified the risk factors that could be relevant to implementing risk-adapted management guidelines, aiming to reduce morbi-mortality in this difficult-to-treat setting.

Datos de la publicación

ISSN/ISSNe:
2072-6694, 2072-6694

Cancers  MDPI

Tipo:
Article
Páginas:
-
PubMed:
40805116
Enlace a otro recurso:
www.scopus.com
Factor de Impacto:
1,349 SCImago ℠
Cuartil:
Q1 SCImago ℠

Citas Recibidas en Web of Science: 1

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Keywords

  • cardiotoxicity; relapse refractory AML; real-world; risk factors; outcomes

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