How to improve quality of life in patients with acute leukemia and comorbid ischemic heart disease treated with anthracycline-based induction chemotherapy

Abstract

Summary. Aim: To evaluate the quality of life (QoL) parameters in patients with acute leukemia (AL) during standard induction chemotherapy, depending on the presence of concomitant ischemic heart disease and to improve them by the prevention of anthracycline cardiotoxicity with L-arginine. Materials and Methods: A total of 147 adult AL patients (72 males and 75 females with the mean age 54.7 ± 9.3 years) were enrolled in the study. QoL assessment was performed at baseline and after induction chemotherapy using SF-36 questionnaire. Both physical and mental parameters were evaluated. Results: The QoL analysis of patients with AL at the time of initial diagnosis showed extremely low QoL level in all subgroups compared with healthy individuals. It should be noted that the level of patients’ QoL after achieving remission remained significantly lower than those of practically healthy, which is primarily due to the need for further long-term treatment and, probably, the fear of the disease relapse development. It was found that the administration of L-arginine during induction chemotherapy in order to reduce the risk of anthracycline cardiotoxicity development has allowed improving the QoL in patients with concomitant ischemic heart disease. Conclusion: L-arginine decreases the risk of anthracycline-induced myocardial injury and improves QoL in AL patients.