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). In this study we aim to evaluate the effectiveness of L-arginine in AC prevention in AL patients with comorbid IHD during induction CT.
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: I (n = 36) – AL patients treated with CT; II (n = 30) – AL patients treated with CT and L-arginine.
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 (p0.5 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.
Clinical trial identification
Legal entity responsible for the study
Ukrainian Medical Stomatological Academy
All authors have declared no conflicts of interest.