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Назва: L-arginine – targeted for the anthracycline cardiotoxicity prevention in patients with acute leukemia of high cardiological risk
Автори: Lymanets, T.
Skrypnyk, I.
Maslova, G.
Скрипник, Ігор Миколайович
Лиманець, Тетяна Володимирівна
Маслова, Ганна Сергіївна
Дата публікації: 2017
Видавець: Annals of Oncology. Official Journal of the European Society for Medical Oncology
Бібліографічний опис: Lymanets T. L-arginine – targeted for anthracycline cardiotoxicity prevention in patients with acute leukemia of high cardiological risk / T. Lymanets, I. Skrypnyk, G. Maslova // Annals of Oncology: Abstract Book of the 42nd ESMO Congress, 8–12 September 2017. – Madrid, 2017. – Vol. 28, Suppl. 5. – P. 366.
Короткий огляд (реферат): The risk of anthracycline cardiotoxicity (AC) significantly increases in patients with comorbid ischemic heart disease (IHD), which requires monitoring and prevention during chemotherapy (CT) of acute leukemia (AL). Aim: To evaluate the effectiveness of L-arginine in AC prevention in AL patients with comorbid IHD during induction CT. Materials and methods. A total 66 patients with newly diagnosed AL and comorbid IHD were included in the study, ECOG I-II. The cohort consisted of 34 (51.5%) males and 32 (48.5%) females, age 54-72 years. The IHD duration was 3–15 years. CT included doxorubicin. We determined the level of troponin I, nitrite anions [NO2]-, performed daily ECG-monitoring: at baseline and in achieving a cumulative dose of anthracyclines (CDA) from 100 to 200 mg/m2. Depending on AC prevention patients were divided into two groups: (n=36) – AL patients treated with CT; II (n=30) – AL patients treated with CT and L-arginine. Results. Prior to CT, according to the daily ECG-monitoring in 47 (71.2%) patients periods of tachycardia were diagnosed, with single supraventricular extrasystoles (SEs) and ventricular extrasystoles (VEs) – in 35 (53%) and 17 (25.7 %) pts, respectively. The decreased concentration of [NO2]- in blood serum in 1.5 times relative to normal values (p˂0.05) was noticed. Troponin I in all patients of both groups was <0.5 ng/ml. Reaching low CDA in group I we recorded: periods of tachycardia in 36 (100%) pts, increasing number of single and paired SEs – in 24 (66.6%), VEs episodes – in 19 (52%), clinically significant ST-segment depression – in 29 (80.5%) and interval QT prolongation – in 14 (38.8%) pts. Troponin I was >0.5 ng/ml in 7 (19.4%) pts. Simultaneously, deepening of endothelial dysfunction (ED) was noted: [NO2]- was in 1.8 times lower vs norm. After 2 CT courses in 20 (66.6%) patients of group II on tachycardia background the single SEs were recorded and only in 1 (3.3%) patient troponin I level was >0.5 ng/ml. The ED leveled: [NO2]- didn’t significantly differ from the norm. Thus, L-arginine in AL patients with comorbid IHD during induction CT leads to reducing the risk of necrotic injury of cardiomyocytes and improves endothelial function that prevents early AC.
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