23 December 2019

Scientists have developed a heart failure risk score for people being treated with anthracyclines for acute lymphoblastic leukaemia (ALL) or acute myeloid leukaemia (AML).

The work was done by Dr Marielle Scherrer-Crosbie and colleagues at the University of Pennsylvania, USA. The team developed a risk score, from 0 to 21, based on tests taken before anthracycline treatment, to predict the patient’s future risk for heart failure.

The score takes into account left ventricular ejection fraction, myocardial strain, and cumulative anthracycline treatment dose. The hope is that the scoring system can be used by oncologists to tailor treatment plans according to risk of cardiotoxicity.

When developing the score, they used measurements from 450 patients with ALL or AML being treated with the chemotherapy drug. About 9% of patients went on to develop heart failure, with a higher rate among the AML group. The median time to heart failure was around 10 months.

Details of the study appeared last week in JACC: CardioOncology.

“While we are more effective at treating cancer, the improved survival rates have helped to unmask the cardiotoxic impact of some of the most common cancer therapies,” Dr Scherrer‑Crosbie said.

“Our hope, in creating this risk score system, is to help clinicians identify patients with the highest risk for potential cardiac damage, so they can more closely monitor the patients via a multidisciplinary approach.”

Lead author, Dr Yu Kang, added: “While this is a significant step toward identifying patient risk for heart failure, additional studies are needed to determine the effectiveness of such a risk score in clinical practice.”



Kang Y, Assuncao BL, Denduluri S, McCurdy S, Luger S, Lefebvre B, Carver J, Scherrer-Crosbie M.  (2019) “Symptomatic Heart Failure in Acute Leukemia Patients Treated With Anthracyclines”, JACC: CardioOncology, doi: 10.1016/j.jaccao.2019.10.008