Ricerc@Sapienza

Anthracyclines (ACT) are effective antineoplastic agents with a broad antitumour spectrum but they can cause cardiotoxicity. This may be acute but also manifest as late causing delayed cardiotoxicity. This is the major limiting factors in the use of these agents. Serial cardiac monitoring prior, during and after treatment is required and left ventricular ejection fraction (LVEF) is the predominant parameter for cardiac dysfunction detection but it appears an unreliable guide.
Despite several biomarkers has been prosed none of this appears a reliable tool to make diagnosis and is able to predict heart damage. Cardiovascular Magnetic Resonance (CMR) has been used to detect cardiac damage. However, the late gadolinium enhancement technique to detect focal fibrosis failed in the majority of the case. ACT cause more likely diffuse myocardial changes missed by this technique. Advanced sequences by CMR (mapping technique) allow now to identify and quantify diffuse fibrosis and oedema in a more robust and reproducible way. Multi-modality approaches may therefore add benefit to investigate the toxic effect of ACT and also guidelines are moving through a multiparametric approach
Accordingly, we sought to perform a serial cardiovascular monitoring in haematological patients treated by ACT with a systematic and multiparametric approach combing clinical and imaging data to detect the earlier marker of cardiac damage able to predict LVEF reduction at one year.
Patients affected by Hodgkin and non-Hodgkin lymphomas, acute myeloid and lymphoblastic leukemia, aged>18 years, with indication to chemotherapy regimen including ACT will be recruited. Only chemotherapy and radiotherapy naïve patients will be recruited excluding patients with cardiovascular disease.
All subjects will be undergone medical assessment, electrocardiogram, echocardiogram with strain evaluation and CMR with mapping technique prior chemotherapy administration, at the end of chemotherapy and after one year.