Cardiac events in newly diagnosed acute myeloid leukaemia during treatment with venetoclax + hypomethylating agents

Br J Haematol. 2024 Apr;204(4):1232-1237. doi: 10.1111/bjh.19325. Epub 2024 Feb 4.

Abstract

Among 301 newly diagnosed patients with acute myeloid leukaemia receiving venetoclax and a hypomethylating agent, 23 (7.6%) experienced major cardiac complications: 15 cardiomyopathy, 5 non-ST elevation myocardial infarction and/or 7 pericarditis/effusions. Four patients had more than one cardiac complication. Baseline characteristics included median age ± interquartile range; 73 ± 5 years; 87% males; 96% with cardiovascular risk factors; and 90% with preserved baseline ejection fraction. In multivariate analysis, males were more likely (p = 0.02) and DNMT3A-mutated cases less likely (p < 0.01) to be affected. Treatment-emergent cardiac events were associated with a trend towards lower composite remission rates (43% vs. 62%; p = 0.09) and shorter survival (median 7.7 vs. 13.2 months; p < 0.01). These observations were retrospectively retrieved and warrant further prospective examination.

Keywords: heart failure; leukaemia; pericarditis; venetoclax.

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / adverse effects
  • Bridged Bicyclo Compounds, Heterocyclic / adverse effects
  • Cardiomyopathies* / etiology
  • Female
  • Humans
  • Leukemia, Myeloid, Acute*
  • Male
  • Retrospective Studies
  • Sulfonamides*
  • Treatment Outcome

Substances

  • venetoclax
  • Bridged Bicyclo Compounds, Heterocyclic
  • Sulfonamides