Identification and protection of early cardiotoxicity in acute myeloid leukemia patients undergoing transplantation

ABSTRACT

Cardiotoxicity of antitumor therapy results in declining survival rates. More specifically, cardiotoxicity is positively correlated with cumulative dose of anthracyclines and eventually develops from reversible to irreversible. In this context, early monitoring methods should be explored for the timely detection of cardiotoxicity and cardioprotective therapy should be performed in patients under consideration for potentially cardiotoxic therapy. This paper reports a 22-year-old male patient with acute myeloid leukemia who underwent whole-course cardiac monitoring after receiving antileukemia therapy. After the early detection of an asymptomatic decrease in left ventricular ejection fraction (LVEF), along with a significant decrease in global longitudinal strain (GLS), the patient was treated with sacubitril/valsartan (Sac/Val). Finally, the patient completed four courses of chemotherapy and subsequent hematopoietic stem cell transplantation as planned. The measurements of LVEF and GLS also recovered after 2 months treatment of Sac/Val. Therefore, the early identification and protection of patients with cardiotoxicity are of paramount importance and future prospective studies are expected to develop the management and treatment of cancer treatment-related cardiac dysfunction.

KEYWORDS:

• Acute myeloid leukemia
• cardiotoxicity
• sacubitril/valsartan
• global longitudinal strain
• cancer treatment-related cardiac dysfunction
• left ventricular ejection fraction
• cardioprotective therapy
• heart failure

Acknowledgements

MW and TJ designed the study and collected the data. MW drafted the manuscript. TJ revised the article and did the final editing. QD, and NZ contributed to the acquisition of data and critically reviewed of the manuscript. XT assisted in study design and critically reviewed the article. All authors read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Statement of ethics

The patient performed all necessary examinations and provided written informed consent to use these examinations for research purposes and publication. This case report was issued in accordance with the World Medical Association Declaration of Helsinki.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.