Symptomatic Heart Failure in Acute Leukemia Patients Treated With Anthracyclines

Area of Science:

• Cardiology and Oncology
• Cardio-oncology
• Hematology

Background:

• Limited data exists on symptomatic heart failure (HF) incidence and risk factors in acute leukemia patients.
• Anthracycline chemotherapy, commonly used for acute leukemia, poses a risk for cardiotoxicity.

Purpose of the Study:

• To investigate the occurrence of HF in acute leukemia patients.
• To develop and validate a predictive risk score for HF in this population.

Main Methods:

• A cohort of 450 acute leukemia patients receiving anthracyclines were assessed for baseline cardiac function (ejection fraction, global longitudinal strain [GLS]).
• Fine and Gray's regression analysis identified risk factors for HF.
• A 21-point risk score was developed using these factors.

Main Results:

• 8.9% of patients developed HF.
• Key predictors for HF included baseline GLS >-15%, reduced ejection fraction, cardiovascular disease, acute myeloid leukemia, cumulative anthracycline dose, and age >60.
• The risk score stratified patients into low, moderate, and high-risk groups with significantly different 1-year HF incidence (1.0%, 13.6%, 35.0%).
• The score also predicted all-cause mortality, though only GLS remained significant after adjustment.

Conclusions:

• A novel baseline risk score effectively predicts HF risk in acute leukemia patients.
• This score aids in identifying high-risk individuals for targeted monitoring and intervention.
• Further research is required to confirm the external validity of this risk score.