Scientific publications
Cardiac Events after Allo-HCT in Patients with Acute Myeloid Leukemia. Study Conducted con Behalf of the GETH-TC. Scientific Publication
M Queralt Salas 1 , Enric Cascos 2 , Alberto Lopez-Garcia 3 , Estefanía Pérez López 4 , Mónica Baile 5 , Carlos Martín-Rodriguez 5 , María Jesús Pascual-Cascón 6 , Marta Luque Garrido 6 , Albert Esquirol 7 , Inmaculada Heras 8 , Felipe Peña-Muñóz 9 , Itziar Oiartzabal Ormategi 10 , Adolfo Jesús Sáez-Marín 11 , Sara Fernández-Luis 12 , Juan Jose Dominguez-Garcia 12 , Sara Villar 13 , Miguel Fernández de Sanmamed Girón 14 , Leslie González-Pinedo 15 , Lucia Garcia-Maño 16 , Ana Pilar Gonzalez-Rodriguez 17 , Tamara Torrado Chedas 18 , Silvia Filafferro 19 , Angel Cedillo 20 , Guillermo Ortí 21 , Manuel Jurado 22
Abstract
This multicenter study sponsored by GETH-TC aimed to investigate the incidence and predictors of early (within the first 100 days) and late cardiac events (CE) (ECE and LCE) following allo-HCT in AML patients treated with anthracyclines, focusing on exploring the impact of PTCY on cardiac complications and the impact of CE on overall survival (OS) and non-relapse mortality (NRM). 1020 AML patients were included.
PTCY was given to 450 (44.1%) adults. Overall, 94 (9.2) patients experienced CE and being arrythmias, pericardial complications, and heart failure the most prevalent ones. ECE occurred in 49 (4.8%) patients in a median of 13 days after allo-HCT, while LCE were diagnosed in 45 (4.4%) patients in a median of 3.6 years after transplant. Using PTCY increased the risk for ECE in multivariate analysis (HR 2.86, P=0.007), but did not not significantly affect the risk for LCE (HR 1.06, P=0.892).
The impact of variables on outcomes revealed was investigated using multivariate regression analyses and revealed that the diagnosis of CE significantly decreased the likelihood of OS (HR 1.66, P=0.005) and increased the likelihood of NRM (HR 2.88, P<0.001). Furthermore, despite using PTCY increased the risk for ECE, its administration was found to be beneficial for OS (HR 0.71, P=0.026).
The study suggests that while the incidence of CE was relatively low, it significantly impacted mortality. Standard doses of PTCY increased ECE risk but were associated with improved OS. Therefore, implementing protocols to prevent cardiac complications is recommended, considering the widespread adoption of PTCY in allo-HCT.
CITATION Blood Adv. 2024 Aug 23:bloodadvances.2024013535. doi: 10.1182/bloodadvances.2024013535
