Risk Score Developed to Help ID Heart Failure Risk in Leukemia

In a study published in the December issue of JACC: CardioOncology, authors investigated the occurrence and developed a risk score to determine the risk for heart failure in patients with acute leukemia treated with anthracyclines.

Yu Kang, M.D., Ph.D., from the Hospital of the University of Pennsylvania in Philadelphia, and colleagues obtained baseline clinical and echocardiographic parameters in 450 patients with acute leukemia treated with anthracyclines before initiation of chemotherapy. A 21-point risk score was generated using potential risk factors for heart failure and was evaluated using regression analysis.

The researchers found that 8.9 percent of patients developed heart failure. The risk score included a baseline global longitudinal strain (GLS) >−15 percent, baseline ventricular ejection fraction <50 percent, preexisting cardiovascular disease, acute myeloid leukemia, cumulative anthracycline dose of ≥250 mg/m², and age >60 years. Patients were stratified into low, moderate, and high risk scores; the estimated one-year cumulative incidence of heart failure was 1.0, 13.6, and 35.0 percent, respectively, for low, moderate, and high risk. The risk score also predicted all-cause mortality. Only GLS was significantly associated with all-cause mortality after adjustment for age and leukemia type (hazard ratio, 1.73).

"With further study, a scoring system may be useful to clinicians to balance the benefits of cancer treatment and potential cardiac damage," the authors write.

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