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Acute myeloid leukemia

Need for routine examination of left ventricular ejection fraction in patients with AML

Leukemia volume 34, pages 1169–1171 (2020)Cite this article

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Anthracyclines are commonly used to treat acute myeloid leukemia (AML). A potentially serious toxicity resulting from their use is left ventricular systolic dysfunction, leading to clinical congestive heart failure (CHF). Many studies have identified age ≥60, smoking, diabetes, hypertension, obesity [1], and higher cumulative dose as risk factors for anthracycline-induced cardiotoxicity [1,2,3,4,5,6,7].

Before initiation of potentially cardiotoxic chemotherapy in asymptomatic patients, American Society for Clinical Oncology (ASCO) guidelines recommend a detailed history and physical examination focused on identifying cardiac risk factors. Based on intermediate-strength level evidence, they suggest obtaining an echocardiogram to ensure adequate cardiac function in patients at higher risk of cardiotoxicity [1]. Similar recommendations have been made by the National Comprehensive Cancer Network (NCCN) [2]. The European Society of Medical Oncology recommends assessing left ventricular ejection fraction (LVEF) in every patient prior to beginning potentially cardiotoxic chemotherapy, such as anthracyclines for AML [3].

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Author information

Authors and Affiliations

  1. University of Washington Internal Medicine Residency Program, Seattle, WA, USA

    Hiba M. Khan

  2. Division of Hematology, Department of Medicine, University of Washington, Seattle, WA, USA

    Kelda M. Gardner, Carole Shaw, Anna B. Halpern, Mary-Elizabeth M. Percival, Pamela S. Becker, Roland B. Walter & Elihu H. Estey

  3. Clinical Research Division, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA

    Anna B. Halpern, Emily M. Huebner, Mary-Elizabeth M. Percival, Sarah Mirahsani, Mohamed L. Sorror, Pamela S. Becker, Roland B. Walter & Elihu H. Estey

  4. Department of Epidemiology, University of Washington, Seattle, WA, USA

    Roland B. Walter

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  1. Hiba M. Khan
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  11. Elihu H. Estey
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Contributions

EE and HK conceived the project, analyzed data, and wrote the paper. KG and CS provided data. AH, EH, MP, SM, MS, RW, and PB provided suggestions.

Corresponding author

Correspondence to Elihu H. Estey.

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Khan, H.M., Gardner, K.M., Shaw, C. et al. Need for routine examination of left ventricular ejection fraction in patients with AML. Leukemia 34, 1169–1171 (2020). https://doi.org/10.1038/s41375-019-0637-z

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