Erschienen in:
28.04.2017 | Original Article
Assessment of late cardiomyopathy by magnetic resonance imaging in patients with acute promyelocytic leukaemia treated with all-trans retinoic acid and idarubicin
verfasst von:
Rebeca Rodríguez-Veiga, Begoña Igual, Pau Montesinos, Mar Tormo, Mª José Sayas, Mariano Linares, José María Fernández, Antonio Salvador, Alicia Maceira-González, Jordi Estornell, Marisa Calabuig, María Pedreño, Mónica Roig, Jaime Sanz, Guillermo Sanz, Carlos Carretero, Blanca Boluda, David Martínez-Cuadrón, Miguel Ángel Sanz, on behalf of the spanish PETHEMA group
Erschienen in:
Annals of Hematology
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Ausgabe 7/2017
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Abstract
Late cardiomyopathy CMP is regarded as a potential severe long-term complication after anthracycline-based regimens for acute promyelocitic leukaemia (APL). We assess by MRI the incidence and severity of clinical and subclinical long-term CMP in a cohort of adult APL patients in first complete remission with PETHEMA trials. Adult patients diagnosed with APL in first complete remission lasting ≥2 years underwent anamnesis and physical examination and were asked to perform a cardiac MRI. Clinical CMP was defined as radiographic and physical signs of heart failure accompanied by symptoms or by left ventricle ejection fraction (LVEF) <45% by MRI with or without symptoms. Subclinical CMP was defined as the following MRI abnormalities: LVEF 45–50% or late gadolinium enhancement or two or more of LVEF ≤55%, left ventricle end-diastolic volume index ≥98 ml/m2, left ventricle end-systolic volume index ≥38 ml/m2, right ventricle end-diastolic volume index ≥106 ml/m2 and regional wall motion abnormalities. Of the 82 patients enrolled in the study, median cumulative dose of anthracyclines (doxorubicin equivalence) was 650 mg/m2, and median time from APL diagnosis to the study was 87 months (range, 24–195). Seven out of 57 patients with available MRI (12%) had subclinical CMP (all of them showed late gadolinium enhancement in MRI), and none had clinical CMP. Among the 25 patients without MRI, none had CMP by chest X-ray and physical assessment. In summary, we found 12% of subclinical and no clinical late CMP assessed by MRI in APL patients treated with PETHEMA protocols. Due to the low number of patients, we must interpret our results cautiously.