Key result
Cardiac biomarkers (NT-proBNP, Troponin T) and reduced LVEF significantly correlated with higher leukocyte and blast cell counts (p<0.05), indicating early anthracycline-induced myocardial dysfunction.
Why the study?
The study was conducted to describe the high-risk profile group susceptible to developing anthracycline-induced cardiomyopathy in children with acute leukemia.
Do biomarkers and echocardiography correlate with leukemia severity markers to evaluate early anthracycline-induced cardiotoxicity risk in pediatric leukemia patients?
Observational (n=35)
Do biomarkers and echocardiography correlate with leukemia severity markers to evaluate early anthracycline-induced cardiotoxicity risk in pediatric leukemia patients?
Biomarkers like NT-proBNP and troponin T, along with echocardiography, are useful for early detection of myocardial dysfunction in pediatric leukemia patients undergoing cytotoxic treatment.
May support intensified monitoring in high-blast-count patients; hypothesis-generating for early anthracycline cardiotoxicity detection.
PURPOSE: To describe the high-risk profile group, susceptible to develop anthracycline-induced cardiomyopathy in children with acute leukemia. METHODS: The study involved 35 pediatric patients diagnosed with acute lymphoblastic (ALL) or acute myeloblastic leukemia (AML), from March 2014 to December 2016. Serologic markers used for the analysis of cardiac dysfunction were troponin T, NT-proBNP and PCRhs. Also, the patients have had echocardiographic evaluation at the beginning of treatment to determine LVEF, SF and A, E, E' Doppler waves. RESULTS: Positive linear correlation was shown between NT-proBNP and leukocyte values, NT-proBNP and blast cells value, and NT-proBNP and LDH. Significant linear negative correlations between LVEF with leukocyte values, blast cells values, LDH, SF and leukocyte values, LVEF and NT-proBNP values and LVEF and troponin T values were also identified. A weak negative correlation between E/E' ratio and blast cells values has been observed. All of these correlations were statistically significant (p<0.05). CONCLUSIONS: Leukocyte value, as well as the other serological markers assessed (NT-proBNP, Troponin T), are useful tools to evaluate the risk of anthracycline-induced cardiotoxicity. The variation of the biological markers at the beginning of the cytotoxic treatment confirms the presence of an early myocardial dysfunction, emphasizing the importance of systematic evaluation of this particular group of patients.
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Maniu et al. (2018) conducted an observational in Acute lymphoblastic (ALL) or acute myeloblastic leukemia (AML) (n=35). Biomarkers (NT-proBNP, Troponin T, PCRhs) and echocardiography was evaluated on Correlation between cardiac biomarkers/echocardiographic parameters and leukocyte/blast cell values (p=<0.05). Cardiac biomarkers (NT-proBNP, Troponin T) and reduced LVEF significantly correlated with higher leukocyte and blast cell counts (p<0.05), indicating early anthracycline-induced myocardial dysfunction.
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