Cardiac events after allo-HCT in patients with acute myeloid leukemia
María Queralt Salas, Enric Cascos, Alberto López‐García, Estefanía Pérez López, Mónica Baile, Carlos Martín‐Rodríguez, María Jesús Pascual-Cascón, Marta Luque, Albert Esquirol, Inmaculada Heras, Felipe Peña-Muñóz, Itziar Oiartzabal Ormategi, Adolfo Sáez, Sara Fernández‐Luis, Juan José Domínguez-García, Sara Villar, Miguel Fernández de Sanmamed Girón, Leslie González-Pinedo, Lucía García-Mañó, Ana Pilar González, Tamara Torrado Chedas, Silvia Filaferro, Ángel Cedillo, Guillermo Ortí, Manuel Jurado Chacón
Abstract
ABSTRACT: This multicenter study sponsored by the GETH-TC investigates the incidence and predictors of early (first 100 days) and late cardiac events (CEs; ECEs and LCEs, respectively) after allo-HCT in patients with acute myeloid leukemia (AML) treated with anthracyclines, focusing on exploring the impact of PTCY on cardiac complications and the impact of CEs on OS and NRM. A total of 1020 patients with AML were included. PTCY was given to 450 (44.1%) adults. Overall, 94 (9.2) patients experienced CEs, with arrythmias, pericardial complications, and heart failure the most prevalent. ECEs occurred in 49 (4.8%) patients within a median of 13 days after allo-HCT, whereas LCEs were diagnosed in 45 (4.4%) patients within a median of 3.6 years after transplant. Using PTCY increased the risk for ECEs in multivariate analysis (hazard ratio [HR], 2.86; P = .007) but did not significantly affect the risk for LCEs (HR, 1.06; P = .892). The impact of variables on outcomes revealed was investigated using multivariate regression analyses and revealed that the diagnosis of CEs decreased the likelihood of OS (HR, 1.66; P = .005) and increased the likelihood of NRM (HR, 2.88; P < .001). Furthermore, despite using PTCY increased ECEs risk, its administration was beneficial for OS (HR, 0.71; P = .026). In conclusion, although the incidence of CEs was relatively low, it significantly affected mortality. Standard doses of PTCY increased ECE risk but were associated with improved OS. Therefore, protocols for preventing cardiac complications among these patients are needed.