Cardiotoxicity of venetoclax in patients with acute myeloid leukemia: comparison with anthracyclines.

IF 3.2 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Cardio-oncology Pub Date : 2024-11-01 DOI:10.1186/s40959-024-00275-5
Takeshi Onoue, Andrew H Matthews, Azin Vakilpour, Yu Kang, Bénédicte Lefebvre, Amanda M Smith, Shannon R McCurdy, Michael G Fradley, Joseph Carver, Jesse Chittams, Marielle Scherrer-Crosbie
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Abstract

Venetoclax is a promising drug for patients with acute myeloid leukemia (AML) ineligible for anthracycline-based treatments. In rats, venetoclax is reported to cause myocardial injury. Our objectives were to report the frequency of cardiovascular (CV) events in patients treated with venetoclax, and, subsequently, to compare CV outcomes in matched patients treated with venetoclax or anthracyclines. Patients diagnosed with AML and treated with venetoclax or anthracyclines from January 2017 to July 2021 were identified. Major adverse cardiac events (MACE, including new-onset heart failure (HF), acute myocardial infarction, new onset atrial fibrillation (AF)) were recorded. Propensity-score method was then used to compare patients treated with venetoclax or anthracyclines. Patients treated with venetoclax (n=103) were older, with more hyperlipidemia than patients treated with anthracyclines (n=217). However, only 63% of patients treated with venetoclax underwent echocardiographic screening (vs. 93% of patients treated with anthracyclines, P< 0.001). Eighteen patients with venetoclax (17%) and 27 patients with anthracyclines (12%) developed MACE, including 10 % of new HF in each group. The median time to MACE was 8 days (interquartile range 5-98 days). In the matched cohort (n=132 patients), the cumulative incidence of MACE at one year was not different (17.5 % venetoclax, 9.2% anthracyclines, p =0.27). Thus, MACE incidence is similar in matched patients receiving venetoclax or anthracyclines. Close CV monitoring during the early phase of treatment may be helpful in patients treated with venetoclax.

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venetoclax对急性髓性白血病患者的心脏毒性:与蒽环类药物的比较。
对于不符合蒽环类药物治疗条件的急性髓性白血病(AML)患者来说,Venetoclax 是一种很有前途的药物。据报道,Venetoclax在大鼠体内可导致心肌损伤。我们的目标是报告接受 Venetoclax 治疗的患者发生心血管 (CV) 事件的频率,并随后比较接受 Venetoclax 或蒽环类药物治疗的匹配患者的 CV 结果。研究对象为2017年1月至2021年7月期间确诊为急性髓细胞白血病并接受文尼他赛或蒽环类药物治疗的患者。记录了主要心脏不良事件(MACE,包括新发心力衰竭(HF)、急性心肌梗死、新发心房颤动(AF))。然后采用倾向分数法对接受 Venetoclax 或蒽环类药物治疗的患者进行比较。接受 Venetoclax 治疗的患者(人数=103)与接受蒽环类药物治疗的患者(人数=217)相比,年龄更大,高脂血症患者更多。然而,只有63%的文尼他赛患者接受了超声心动图筛查(与93%的蒽环类药物患者相比,P< 0.001)。18名接受venetoclax治疗的患者(17%)和27名接受蒽环类药物治疗的患者(12%)发生了MACE,包括每组中10%的新发HF。发生 MACE 的中位时间为 8 天(四分位数间距为 5-98 天)。在配对队列(n=132 例患者)中,一年后 MACE 的累积发生率没有差异(17.5% venetoclax,9.2% anthracyclines,p =0.27)。因此,接受文尼他克或蒽环类药物治疗的配对患者的 MACE 发生率相似。在治疗早期阶段密切监测心血管疾病可能对接受 Venetoclax 治疗的患者有帮助。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Cardio-oncology
Cardio-oncology Medicine-Cardiology and Cardiovascular Medicine
CiteScore
5.00
自引率
3.00%
发文量
17
审稿时长
7 weeks
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