Abstract

Summary

To evaluate the clinical manifestations, laboratory characteristics, and cardiovascular changes in patients with acute lymphoblastic leukemia (ALL) at initial presentation and during repeated hospitalizations for polychemotherapy.
 

Materials and Methods

In 2018, 81 patients with acute lymphoblastic leukemia, aged 16 to 80, were monitored in the hematology department of the Shifobakhsh National Medical Center of the Republic of Tatarstan. Of the 81 patients with ALL, 48 were newly admitted, including 28 men and 20 women. Among 81 patients with ALL, 48 were newly admitted, including 28 men and 20 women, with men predominating (58.3%). All patients underwent complete blood count, biochemical tests, sternal puncture with cytochemical analysis, ECG, and echocardiography. 
 

Results

Of the newly admitted ALL patients, 91.6% presented with anemic syndrome, with 35 cases of severe anemia. Anemia was more severe in men, with hemoglobin levels ranging from 37 g/L to 76 g/L, which influenced the clinical course of the disease. Low hemoglobin levels were also noted in re-admitted ALL patients. Severe anemia, with hemoglobin levels between 60 g/L and 80 g/L, was observed in 33.3% of cases, while gradual normalization of hemoglobin was recorded in 24.2% of patients. In newly admitted patients, tachycardia was detected in 91.6% of cases, repolarization disturbances in 75%, and chest pain in 54.1%. In re-admitted patients who had undergone polychemotherapy, ECG changes progressed: repolarization disturbances reached 78,7%, and left ventricular hypertrophy was observed in 18% of cases. 

Conclusion

Leukemic anemia, leukemic infiltration of the heart, and chemotherapy cardiotoxicity mutually aggravate cardiovascular involvement. Timely correction of anemia and cardiotoxicity monitoring are essential to improve the quality of life in ALL patients.
 

Keywords

acute lymphoblastic leukemia cardiotoxicity anemia ECG cardio-oncology chemotherapy cardiovascular complications.

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