Clinical outcomes of patients with acute myeloid leukemia and cardiovascular disease.

Autor: Sanchez-Petitto G; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA., Goloubeva OG; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA; Department of Epidemiology and Public Health. University of Maryland School of Medicine, Baltimore, MD, USA., Masur J; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA., Childress J; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA., Iqbal T; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA., An M; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA., Muhammad S; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA., Lawson J; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA., Li G; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA., Barr B; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA., Emadi A; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA., Law JY; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA., Lee ST; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA., Duong VH; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA., Baer MR; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA., Niyongere S; University of Maryland Greenebaum Comprehensive Cancer Center, Baltimore, MD, USA; Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA. Electronic address: Sandrine.niyongere@umm.edu.
Jazyk: angličtina
Zdroj: Leukemia research [Leuk Res] 2024 Mar; Vol. 138, pp. 107456. Date of Electronic Publication: 2024 Feb 20.
DOI: 10.1016/j.leukres.2024.107456
Abstrakt: Incidence of both acute myeloid leukemia (AML) and cardiovascular disease (CVD) increases with age. We evaluated whether pre-existing CVD impacts clinical outcomes in AML. We retrospectively evaluated 291 consecutive adult AML patients treated at our institution, 2014-2020. Pretreatment comorbidities were identified by chart review. Outcomes included complete remission (CR) and CR with incomplete count recovery (CRi) rates, disease-free survival (DFS), overall survival (OS) and incidence of cardiovascular adverse events. CVD was present in 34% of patients at AML diagnosis. CVD patients had worse performance status (p=0.03) and more commonly had secondary AML (p=0.03) and received hypomethylating (HMA) agent-based therapy (72% vs 38%, p< 0.001). CVD (0.45 vs 0.71, p<0.001) and diabetes mellitus (HR= 0.24, 95% CI: 0.08 - 0.8, p= 0.01) were associated with lower probability of achieving CR/CRi. Accounting for age, performance status (PS), complex karyotype, secondary disease and treatment, CVD patients had shorter OS (HR=1.5, 95% CI: 1.1-2.2, p=0.002), with 1- and 3-year OS 44% vs 67% and 25% vs 40%, respectively, but there was no difference in cumulative incidence of relapse between patients with vs without CVD. Thus, CVD is an independent risk factor for lower response rate and shorter survival in AML patients.
Competing Interests: Declaration of Competing Interest The authors declare no potential conflicts of interest.
(Copyright © 2024 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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