Congestive heart failure among children with acute leukemia: a population-based matched cohort study

Area of Science:

• Pediatric Oncology
• Cardiology
• Hematology

Background:

• Congestive heart failure (CHF) is a serious concern in pediatric cancer survivors.
• Understanding the incidence and risk factors for CHF in children with leukemia is crucial for long-term survivorship care.

Purpose of the Study:

• To determine the incidence and identify risk factors for congestive heart failure (CHF) in children diagnosed with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML).

Main Methods:

• Retrospective cohort study of 2053 children (≤18 years) diagnosed with ALL or AML between 1992-2010.
• Utilized linked administrative databases to identify CHF events.
• Analyzed demographic, treatment (irradiation, anthracycline dose), and outcome data.

Main Results:

• The 10-year cumulative incidence of CHF was 1.7% for ALL and 7.5% for AML.
• In ALL patients, risk factors for CHF included female gender, age <1 year at diagnosis, irradiation, and cumulative anthracycline dose ≥250 mg/m².
• Irradiation was the sole identified risk factor for CHF in AML patients.
• Of 23 patients experiencing CHF during therapy, only one developed it after treatment completion.

Conclusions:

• Children with AML have a higher incidence of CHF compared to those with ALL.
• Irradiation is a significant risk factor for CHF in pediatric leukemia survivors.
• Most CHF events occur during active cancer therapy, with a low incidence post-treatment completion.