急性髓系白血病患者异基因 HCT 后的心脏事件。代表 GETH-TC 进行的研究。
Cardiac Events after Allo-HCT in Patients with Acute Myeloid Leukemia. Study Conducted con Behalf of the GETH-TC.
发表日期：2024 Aug 23
作者：
M Queralt Salas, Enric Cascos, Alberto Lopez-Garcia, Estefanía Pérez López, Mónica Baile, Carlos Martín-Rodriguez, María Jesús Pascual-Cascón, Marta Luque Garrido, Albert Esquirol, Inmaculada Heras, Felipe Peña-Muñóz, Itziar Oiartzabal Ormategi, Adolfo Jesús Sáez-Marín, Sara Fernández-Luis, Juan Jose Dominguez-Garcia, Sara Villar, Miguel Fernández de Sanmamed Girón, Leslie González-Pinedo, Lucia Garcia-Maño, Ana Pilar Gonzalez-Rodriguez, Tamara Torrado Chedas, Silvia Filafferro, Angel Cedillo, Guillermo Ortí, Manuel Jurado
来源：
MOLECULAR & CELLULAR PROTEOMICS
摘要：
这项由 GETH-TC 赞助的多中心研究旨在调查接受蒽环类药物治疗的 AML 患者异基因 HCT 后早期（前 100 天内）和晚期心脏事件 (CE)（ECE 和 LCE）的发生率和预测因素，重点探讨PTCY 对心脏并发症的影响以及 CE 对总生存期 (OS) 和非复发死亡率 (NRM) 的影响。纳入 1020 名 AML 患者。 450 名成人 (44.1%) 接受了 PCY。总体而言，94 名 (9.2) 名患者经历了 CE，心律失常、心包并发症和心力衰竭是最常见的。 49 名 (4.8%) 患者在异基因 HCT 后平均 13 天发生 ECE，而 45 名 (4.4%) 患者在移植后平均 3.6 年诊断出 LCE。多变量分析显示，使用 PTCY 增加了 ECE 风险（HR 2.86，P=0.007），但并未显着影响 LCE 风险（HR 1.06，P=0.892）。使用多元回归分析研究了变量对结果的影响，结果显示，CE 的诊断显着降低了 OS 的可能性（HR 1.66，P=0.005），并增加了 NRM 的可能性（HR 2.88，P<0.001）。此外，尽管使用 PTCY 增加了 ECE 风险，但其管理被发现对 OS 有益（HR 0.71，P=0.026）。研究表明，虽然 CE 的发生率相对较低，但它显着影响死亡率。标准剂量的 TCY 会增加 ECE 风险，但与 OS 改善相关。因此，考虑到 PTCY 在 allo-HCT 中的广泛采用，建议实施预防心脏并发症的方案。版权所有 © 2024 美国血液学会。
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.Copyright © 2024 American Society of Hematology.