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Cardiac function in survivors of childhood acute myeloid leukemia treated with chemotherapy only: a NOPHO ‐ AML study
Author(s) -
Jarfelt Marianne,
Andersen Niels H.,
Glosli Heidi,
Jahnukainen Kirsi,
Jónmundsson Guðmundur K.,
Malmros Johan,
Nysom Karsten,
Hasle Henrik
Publication year - 2016
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.12683
Subject(s) - myeloid leukemia , medicine , chemotherapy , myeloid , function (biology) , oncology , immunology , biology , genetics
Objectives We report cardiac function of patients treated for Childhood acute myeloid leukemia with chemotherapy only according to three consecutive Nordic protocols. Methods Ninety‐eight of 138 eligible patients accepted examination with standardized echocardiography. Results were compared with age‐ and sex‐matched controls. Results The median age was 3 yr at diagnosis (range 0–15), and the median time from diagnosis to study was 11 yr (4–25). All but one patient had received doxorubicin and 90% had received mitoxantrone. The median cumulative dose of daunorubicin equivalents was 300 mg/m 2 (210–525). Left ventricular fractional shortening ( LVFS ) and ejection fraction ( LVEF ) were lower in patients than in controls (32.6% ( SD 4.0) vs. 35.2% ( SD 3.4), P = 0.002 and 59.9% ( SD 5.5) vs. 64.2% ( SD 4.4), P = 0.001). The myocardial performance index ( MPI ) was higher in patients than in controls (0.32 ( SD 0.081) vs. 0.26 ( SD 0.074), P < 0.0001). Cumulative dose of doxorubicin but not mitoxantrone was related to lower LVFS ( P = 0.037) and LVEF ( P = 0.016). Longer follow‐up was associated with lower LVFS ( P = 0.034). Higher MPI was associated with young age at diagnosis ( P = 0.04) and longer follow‐up ( P = 0.031). Conclusions In this study, most patients had cardiac function within normal limits and reported very few cardiac symptoms. However, compared with healthy controls, they had significantly reduced left ventricular function.