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复发性AML的儿童和青少年中CPX-351的心脏毒性:儿童瘤学小组的报告
Kasey J Leger1, Michael J Absalon2, Biniyam G Demissei3
1Division of Pediatric Hematology/Oncology, Seattle Children's Hospital, University of Washington, Seattle, WA, United States.
Frontiers in cardiovascular medicine
|July 1, 2024
概括
在患有复发性急性髓性白血病 (AML) 的儿童中,CPX-351治疗显示左心室喷射率 (LVEF) 减少,心脏生物标志物增加. 需要进一步的研究来评估长期的心脏功能影响.
科学领域:
- 心脏病学 心脏病学
- 儿科瘤学 儿科瘤学
- 药理学 药理学是指药理学的学科.
背景情况:
- 人环素是有效的AML治疗方法,但引起心脏毒性.
- CPX-351是一种脂质体配方的诺鲁比和细胞氨基,可能提供一个更安全的替代品.
- 在患有复发性AML的儿科患者中评估CPX-351的心脏安全性至关重要.
研究的目的:
- 在患有复发性AML的儿童接受CPX-351治疗后,评估左心室缩功能和心脏生物标志物的急性变化.
- 在这个脆弱人群中确定与CPX-351相关的潜在心脏毒性.
- 为了比较CPX-351的心脏效应与已知的炭环素心脏毒性.
主要方法:
- 患有AML复发的儿童在1,3和5日接受了CPX-351 (135单位/m2/剂量).
- 在基线和循环1结束时进行心声图,以测量LVEF.
- 包括hs-cTnT和NT-proBNP在内的心脏生物标志物被连续测量.
主要成果:
- 在先前接受过环素治疗的儿童中,LVEF在CPX-351后显著下降 (ΔLVEF -3.3%).
- 与癌症治疗相关的心脏功能障碍 (CTRCD) 在24%的受试者中发生.
- hs-cTnT水平略有增加,而NT-proBNP则保持稳定.
结论:
- 在先前治疗的儿科AML患者中,CPX-351治疗导致LVEF降低和hs-cTnT增加.
- 基线心脏功能异常在这个受重治疗的队列中很常见.
- 长期的心脏影响需要在正在进行的试验中进一步调查.
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