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Abstract
The effect of calcium channel blockers (CCBs), beta blockers and angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) on the prognosis of patients with acute myeloid leukemia (AML) is largely unknown. We collected data on the use of these medications in 1043 patients with AML, excluding promyelocytic leukemia, diagnosed and treated at M. D. Anderson Cancer Center between 2000 and 2012. Treatment with either amlodipine or diltiazem predicted a worse overall survival (hazard ratio [HR] 1.6, 95% confidence interval [CI] 1.22–2.06, p < 0.0001). There was no difference in survival depending on whether patients were taking beta blockers, ACE inhibitors or ARBs. The effect of CCBs on survival was independent from the National Comprehensive Cancer Network risk classification, age, performance status, response to treatment, year of diagnosis and CD34 levels, assessed by flow cytometry (HR 1.39, 95% CI 1.05–1.80, p = 0.02). Treatment with either amlodipine or diltiazem predicts worse survival in patients with AML independent of known prognostic factors.
Acknowledgements
This study was supported by a grant from the ASCO Young Investigator Award (to Y.K.C.) and, in part, supported by funding from the National Cancer Institute (CA55164, CA100632) and the Haas Chair in Genetics (to M.A.).
The authors wish to thank pharmacists, including Deborah McCue, for providing the comprehensive pharmacological data that enabled this study. They are also indebted to the physicians of the leukemia department that treated the patients reported here.
Potential conflict of interest:
Disclosure forms provided by the authors are available with the full text of this article at www.informahealthcare.com/lal.