Cardiotoxicity in Adult Patients with Relapsed or Refractory Acute Myeloid Leukemia
Laura Torres-Miñana1,2, Blanca Boluda1,2, Antonio Solana-Altabella2,3
1Hematology Department, Hospital Universitari i Politècnic La Fe, 46026 València, Spain.
Cancers
|August 14, 2025
Summary
Cardiac events are common in relapsed/refractory acute myeloid leukemia (AML) patients, with significant morbidity. Identifying risk factors like prior cardiac history and intensive chemotherapy is crucial for managing cardiotoxicity in AML.
Area of Science:
- Hematology
- Cardiology
- Oncology
Background:
- Cardiac morbimortality in relapsed/refractory (R/R) acute myeloid leukemia (AML) is not well-defined.
- Understanding cardiac event incidence and risk factors is critical for patient outcomes.
Purpose of the Study:
- To analyze the characteristics, incidence, risk factors, and outcomes of cardiac events in R/R AML patients undergoing second-line (2L) or third-line (3L) treatment.
- To identify key factors contributing to cardiac complications in this patient population.
Main Methods:
- Retrospective analysis of 327 2L AML patients and 189 3L AML patients.
- Evaluation of cardiac event incidence, types, and associated risk factors.
- Multivariate analysis to identify independent risk factors for cardiac events.
Main Results:
- In the 2L cohort, 38.6% experienced non-fatal cardiac events and 1.3% fatal events at 6 months. Hypertension, bradycardia, and QTc prolongation were most frequent.
- Grade 3-4 cardiac events occurred in 23.5% of 2L patients, associated with poorer overall survival (OS).
- Prior cardiologic history, intensive 2L chemotherapy, and clinical trial inclusion were independent risk factors for non-fatal cardiac events in 2L AML.
Conclusions:
- Cardiotoxicity is a frequent and significant complication in R/R AML patients.
- Identified risk factors can inform the development of risk-adapted management guidelines.
- Implementing these guidelines may help reduce cardiac morbidity and mortality in R/R AML.
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