CLINICAL AND CARDIOGRAPHIC CHANGES IN PATIENTS WITH ACUTE LYMPHOBLASTIC LEUKAEMIA AND METHODS FOR THEIR CORRECTION
Keywords:
acute lymphoblastic leukemia, cardiotoxicity, ECG, EchoCG, chemotherapy, cardioprotectionAbstract
Objective: To analyze the clinical and electrocardiographic changes in patients with acute lymphoblastic leukemia (ALL) and evaluate the methods of their correction. Materials and Methods: The study included 40 patients aged 18 to 40 years with newly diagnosed ALL who underwent polychemotherapy. ECG and EchoCG were performed before and after treatment. Additional tests included complete blood count, urinalysis, lipid profile, coagulation time, and coagulation profile. Results: Electrocardiographic abnormalities were found in 90% of patients, including sinus tachycardia, extrasystoles, atrial fibrillation, ST segment changes, and QTc prolongation. EchoCG showed reduced left ventricular ejection fraction in 75% of patients. Cardioprotective therapy and regular monitoring improved outcomes. Conclusion: Cardiographic monitoring is essential in ALL treatment to prevent and correct cardiotoxicity. Cardioprotective agents such as ACE inhibitors and dexrazoxane are recommended.
References
Армениан Ш. и др. Кардиотоксичность у пациентов после химиотерапии: современные подходы. – 2019.
Вежпонгса П., Йе Э.Т. Кардиопротекция при применении антрациклинов: вызовы и возможности // J Am Coll Cardiol. – 2024.
Кьюрилиано Г. и др. Кардиотоксичность химиотерапии и рекомендации ESMO // Annals of Oncology. – 2025.
Lotrionte M., Biondi-Zoccai G., Abbate A., et al. Review and meta-analysis of incidence and clinical predictors of anthracycline cardiotoxicity // Am J Cardiol. – 2022.
Zhang S, Liu X, Bawa-Khalfe T, et al. Identification of the molecular basis of doxorubicin-induced cardiotoxicity. Nat Med. – 2018.
2025)
Bertrand É., Caru M., Harvey A., Dodin P., Jacquemet V., Curnier D. Cardiac electrical abnormalities in childhood acute lymphoblastic leukemia survivors: A systematic review // Cardio-Oncology. – 2023. – Vol. 9: 40. doi:10.1186/s40959-023-00188-9. 
Bertorello N. et al. Exploring the baseline cardiac function and its correlation with risk stratification in children diagnosed with acute lymphoblastic leukemia // Annals of Hematology. – 2025. 
Lazar D.R., Cainap S., Maniu D., Blag C., Bota M., Lazar F.-L., Achim A., Colceriu M.C., Zdrenghea M. Anthracycline’s effects on heart rate variability in children with acute lymphoblastic leukemia: Early toxicity signs—Pilot study // Journal of Clinical Medicine. – 2023. – Vol. 12(22): 7052. doi:10.3390/jcm12227052.  
Joseph T., Sanchez J., Abbasi A., Duong T.Q. Cardiotoxic effects following CAR-T cell therapy: A literature review // Current Oncology Reports. – 2025. – Vol. 27: 135–147. doi:10.1007/s11912-024-01634-2
