Early Lymphocyte Dynamics and Subsequent Cancer Therapy-Related Cardiac Dysfunction in Patients Receiving Anthracycline Therapy

A less pronounced early decline in lymphocyte percentage after anthracycline initiation is linked to higher odds of subsequent CTRCD in 362 adults, with OR 1.96 at the 90th percentile.

• Why it matters: Early lymphocyte dynamics could help identify patients at risk for cancer therapy–related cardiac dysfunction, but the association after anthracyclines has been uncertain.
• What they did: In MIMIC-IV (with linked MIMIC-IV-Echo), relative lymphocyte percentage change from baseline to the 0–30-day nadir was modeled with multivariable logistic regression and restricted cubic splines. CTRCD was defined as LVEF decline ≥10 percentage points to <53%.
• The result: Among 362 patients, 58 (16.0%) developed CTRCD; early lymphocyte change showed overall association (P=0.031) and remained consistent after sequential and hematologic adjustment. Adding lymphocyte change to a clinical model increased optimism-corrected AUC from 0.644 to 0.658 (P=0.040).