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在急性髓性白血病中,与环素相关的左心室功能障碍的发生率和预测因素
Maximilian Stahl1, Gerard Giblin2, Yiwen Liu3
1Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.
Leukemia research
|July 14, 2023
概括
与人类循环素相关的左心室功能障碍 (ARLVD) 发生在8%的急性髓性白血病 (AML) 患者中. JAK2突变,而不是并发症,预测了ARLVD风险,这很少影响干细胞移植的资格.
科学领域:
- 心脏病学 心脏病学
- 血液学 血液学 血液学
- 在瘤学瘤学.
背景情况:
- 抗环素化疗是急性髓性白血病 (AML) 的标准治疗方法.
- 与人环素相关的左心室功能障碍 (ARLVD) 是已知的风险.
- 在现代时代,ARLVD的预测因子和发病率尚不清楚.
研究的目的:
- 确定在接受 antracycline 化疗的 AML 患者中ARLVD 的发病率.
- 为了确定ARLVD的临床和遗传预测因素.
- 评估ARLVD对异性干细胞移植 (allo-SCT) 资格的影响.
主要方法:
- 对419名成年AML患者 (2014-2022) 的回顾性研究.
- 纳入标准:抗环素化疗,化疗前/后的LVEF,治疗前的LVEF>50%,以及下一代测序.
- ARLVD定义为诱导后的LVEF<50%.
主要成果:
- 34名 (8%) 患者发生了ARLVD.
- 基线心血管并发症和反环素剂量没有预测效果.
- JAK2突变的存在显著增加了ARLVD风险 (OR 8.34,p=0.007).
- 在符合条件的患者中,ARLVD仅在1%的患者中排除了alo-SCT.
结论:
- 在AML患者中,ARLVD不常见,基线LVEF正常.
- JAK2突变是ARLVD的一个重要遗传预测因子.
- 在这个群体中,ARLVD很少影响SCT资格.
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