Relapsed Acute Myeloid Leukemia - An Assessment of Treatment, Cardiotoxicity and Outcomes
Mentor: Kelly Getz
Acute Myeloid Leukemia (AML) is the second most common pediatric blood cancer, and the most threatening. It requires treatment with multiple intensive rounds of chemotherapy. However, these chemotherapy treatments can lead to cardiotoxicity, or impaired heart function, in up to 40% of pediatric patients. This decrease in cardiac function may persist even after treatment ends and can even progress to heart failure. Cardiotoxicity can result in changes to treatment dosage and plan, and early cardiotoxicity is associated with dramatically decreased survival. Despite this association, there is relatively little research on the influence cardiotoxicity has on patient outcomes during relapse, or whether early detection and treatment of cardiac dysfunction leads to better outcomes in pediatric AML patients. During my summer research experience, I will be working to fill some of those research gaps though my contribution to two of Dr. Getz’s studies investigating the impact of cardiotoxicity and cardioprotective therapies on AML patient treatment and outcomes.
The first project aims to evaluate the ability of salvage chemotherapy and stem cell transplant to explain the association between cardiotoxicity onset during frontline therapy and decreased overall survival. 30-40% of AML patients eventually relapse and require further rounds of intense chemotherapy or stem cell transplantation. This study will investigate how cardiotoxicity during initial therapy could affect the choice of, or response to, relapse therapies and potentially cause worse overall survival. The second project aims to evaluate whether using cardiac-directed therapies to protect heart function during frontline chemotherapy improves relapse risk and overall survival in AML. It also aims to understand whether any improvements in these two areas are explain by modifications of frontline treatment or preserved cardiac function at the end of treatment.
