Influencing factors of anthracycline-induced subclinical cardiotoxicity in acute leukemia patients

作者全名："Zhou, Xi; Weng, Yue; Jiang, Tiantian; Ou, Wenxin; Zhang, Nan; Dong, Qian; Tang, Xiaoqiong"

作者地址："[Zhou, Xi; Weng, Yue; Jiang, Tiantian; Ou, Wenxin; Tang, Xiaoqiong] Chongqing Med Univ, Affiliated Hosp 1, Dept Hematopathol, Chongqing, Peoples R China; [Zhang, Nan; Dong, Qian] Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiol, Chongqing, Peoples R China"

通信作者："Tang, XQ (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Hematopathol, Chongqing, Peoples R China.; Dong, Q (通讯作者)，Chongqing Med Univ, Affiliated Hosp 1, Dept Cardiol, Chongqing, Peoples R China."

来源：BMC CANCER

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001099644300005

JCR分区：Q2

影响因子：3.4

年份：2023

卷号：23

期号：1

开始页：　

结束页：　

文献类型：Article

关键词：Acute leukemia; Anthracycline; Subclinical cardiotoxicity; Influencing factors

摘要："Background Current treatment of acute leukemia is based on anthracycline chemotherapy. Anthracyclines, despite improving patient survival, have serious cardiotoxicity and therefore cardiac monitoring should be a priority. The purpose of this study is to explore the possible early predictors of anthracycline-induced subclinical cardiotoxicity(AISC)in acute leukemia patients.Methods We conducted a prospective observational study involving 51 patients with acute leukemia treated with anthracycline. Demographic data, clinical variables, echocardiography variables and biochemical variables were collected at baseline and after 3 cycles of chemotherapy. Patients were divided into the AISC and No-AISC groups according to changes of global longitudinal peak systolic strain. Regression models and receiver operating characteristic curve analysis were used to explore the relationship between the variables and AISC.Result 17 of the patients suffered subclinical cardiotoxicity after 3 cycles of anthracycline treatment. Multiple logistic regression analysis showed a significant association of DBil (OR 0.612, 95% CI 0.409-0.916, p = 0.017), TBil (OR 0.841, 95% CI 0.717-0.986, p = 0.033), PLT (OR 1.012, 95% CI 1.002-1.021, p = 0.016) and Glu (OR 1.873, 95% CI 1.009-3.475, p = 0.047) with the development of AISC. After 3 cycles of chemotherapy, there was a significant difference in PLT between the AISC and NO-AISC groups. Moreover, the dynamic changes in PLT from baseline to after 3 cycles of chemotherapy were each statistically significant in the AISC and NO-AISC groups. The combination of PLT and N-terminal pro-B-type natriuretic peptide (NT-proBNP) had the highest area under curves (AUC) for the diagnosis of AISC than PLT and NT-proBNP alone (AUC = 0.713, 95%CI: 0.56-0.87, P = 0.017).Conclusion Total bilirubin (TBil), direct bilirubin (DBil), platelets (PLT) and blood glucose (Glu) are independent influencing factors for AISC in acute leukemia patients receiving anthracycline therapy. Bilirubin may be a protective factor and PLT may be a contributing factor for AISC. The combination of baseline PLT and baseline NT-proBNP shows satisfactory predictive ability for AISC in acute leukemia cases treated with 3 cycles of chemotherapy."

基金机构：We wish to thank the other participants for their contributions as well as all patients for their cooperation.

基金资助正文：We wish to thank the other participants for their contributions as well as all patients for their cooperation.