Anthracycline-Induced Cardiotoxicity in Acute Myeloid Leukemia Patients Who Undergo Allogeneic Hematopoietic Stem Cell Transplantation
Anthracycline-Induced Cardiotoxicity in Acute Myeloid Leukemia Patients Who Undergo Allogeneic Hematopoietic Stem Cell Transplantation
复制标题
DOI：
10.1016/j.clml.2019.03.007
复制
发表时间：
2019-07-01
影响因子：
2.7
通讯作者：
Raanani, Pia
中科院分区：
文献类型：
--
作者：
Pasvolsky, Oren;Morelli, Olga;Raanani, Pia
心功能损害对造血干细胞移植（HSCT）的结局有不利影响。因此，我们在78例接受HSCT的急性髓性白血病患者中研究了含蒽环类药物诱导方案的急性心脏毒性。14例患者（18%）发展成剂量依赖性收缩功能障碍，收缩功能恶化与较差的生存outcome.Introduction：有关于蒽环类药物治疗的心脏毒性作用的背景下进行异基因造血干细胞移植（HSCT）的急性髓细胞白血病（AML）患者的数据匮乏。即使是心脏功能的短暂下降也可能影响移植结果。患者和方法：我们回顾了78例接受诱导治疗并接受HSCT的AML患者的临床记录和超声心动图检查。结果如下：22例患者（28%）接受柔红霉素，剂量为90 mg/m2/d，53例患者（68%）接受60 mg/m2/d或等效剂量的伊达洛酮。14例患者（18%）诱导后射血分数下降至少10%。这种变化在6例患者中是暂时的，在其余患者中是长期的。发生收缩功能障碍的患者总生存期较低（13个月与27个月; P = 0.013）。舒张功能恶化的患者生存期延长（38个月比17个月; P = 0.048）。结论：虽然即使是短暂的收缩功能下降可能会影响生存结果，舒张功能障碍预测改善生存的AML患者接受HSCT。
Impairment of cardiac function adversely affects the outcome of hematopoietic stem cell transplantation (HSCT). Therefore, we studied the acute cardiotoxic potential of anthracycline-containing induction regimens in 78 patients with acute myeloid leukemia who underwent HSCT. Fourteen patients (18%) developed dose-dependent systolic dysfunction, and deterioration of systolic function was associated with inferior survival outcome.Introduction: There is paucity of data regarding the cardiotoxic effects of anthracycline treatment in the context of acute myeloid leukemia (AML) patients who undergo allogeneic hematopoietic stem cell transplantation (HSCT). Even a transient decrease in cardiac function might affect transplantation outcome. Patients and Methods: We reviewed the clinical records and echocardiography examinations of 78 patients with AML who received induction therapy and underwent HSCT. Results: Twenty-two patients (28%) received daunorubicin at a dose of 90 mg/m(2) per day and 53 patients (68%) received 60 mg/m(2) per day or an equivalent dose of idarubicin. In 14 patients (18%) the postinduction ejection fraction declined by at least 10%. This change was temporary in 6 patients and longstanding in the remainder. Patients who developed systolic dysfunction had inferior overall survival (13 months compared with 27 months; P = .013). Patients whose diastolic function deteriorated had improved survival outcome (38 months compared with 17 months; P = .048). Conclusion: Although even transient reduction in systolic function might compromise survival outcome, diastolic dysfunction predicts improved survival in patients with AML who undergo HSCT.