BACKGROUND: Premature cardiovascular mortality related to chemotherapy and occurred in lymphoma survivors before disease progression is one of significant clinical failure of modern hematology. The aim of this retrospective analysis was to evaluate early cardiovascular mortality and its predictors in patients treated with the (R)-CHOP regimen. METHODS: The study assessed 610 patients: 581 patients were treated with non-liposomal doxorubicin (cumulative dose of 337 ± 96 mg/m2), and 29 patients with liposomal non-pegylated doxorubicin (cumulative dose of 237 ± 126 mg/m2). Their present status, history of cardiovascular diseases and associated risk factors were recorded. RESULTS: The analysis identified 93 deaths (15.5%): 51 cases (55%) related to lymphoma disease progression and 28 (30%) to cardiovascular complications. Multivariate Cox analysis revealed history of previous heart diseases (HR=4.71; CI: 3.82-5.6; p<0.001), ECG rhythm abnormalities related to chemotherapy (HR=4,78; CI: 3.63-5.92; p=0,01), and lack of complete remission (HR=2.73; CI: 1.78-3.66; p=0.03), as the independent predictors for cardiovascular death. Neither decreased LVEF nor increasing cumulative dose of anthracyclines had a significant predictive value for cardiovascular prognosis. CONCLUSIONS: The study indicated that cardiovascular mortality in lymphoma patients treated with (R)-CHOP regimen is relatively high and ECG monitoring may be the most effective in cardiological risk assessment. The unfavorable outcome depended on lack of complete remission that seems to be a consequence of patients' individual susceptibility for cardiac events, which should become a purpose of further trials.
BACKGROUND: Premature cardiovascular mortality related to chemotherapy and occurred in lymphoma survivors before disease progression is one of significant clinical failure of modern hematology. The aim of this retrospective analysis was to evaluate early cardiovascular mortality and its predictors in patients treated with the (R)-CHOP regimen. METHODS: The study assessed 610 patients: 581 patients were treated with non-liposomal doxorubicin (cumulative dose of 337 ± 96 mg/m2), and 29 patients with liposomal non-pegylated doxorubicin (cumulative dose of 237 ± 126 mg/m2). Their present status, history of cardiovascular diseases and associated risk factors were recorded. RESULTS: The analysis identified 93 deaths (15.5%): 51 cases (55%) related to lymphoma disease progression and 28 (30%) to cardiovascular complications. Multivariate Cox analysis revealed history of previous heart diseases (HR=4.71; CI: 3.82-5.6; p<0.001), ECG rhythm abnormalities related to chemotherapy (HR=4,78; CI: 3.63-5.92; p=0,01), and lack of complete remission (HR=2.73; CI: 1.78-3.66; p=0.03), as the independent predictors for cardiovascular death. Neither decreased LVEF nor increasing cumulative dose of anthracyclines had a significant predictive value for cardiovascular prognosis. CONCLUSIONS: The study indicated that cardiovascular mortality in lymphomapatients treated with (R)-CHOP regimen is relatively high and ECG monitoring may be the most effective in cardiological risk assessment. The unfavorable outcome depended on lack of complete remission that seems to be a consequence of patients' individual susceptibility for cardiac events, which should become a purpose of further trials.
Authors: Szymon Darocha; Michał Wilk; Anna Walaszkowska-Czyż; Jarosław Kępski; Rafał Mańczak; Marcin Kurzyna; Adam Torbicki; Sebastian Szmit Journal: In Vivo Date: 2018 Mar-Apr Impact factor: 2.155
Authors: Monika Długosz-Danecka; Sebastian Szmit; Tomasz Ogórka; Aleksander B Skotnicki; Wojciech Jurczak Journal: Cancer Med Date: 2019-02-10 Impact factor: 4.452
Authors: Qianwei Liu; Therese Ml Andersson; Anna Jöud; Qing Shen; Maria Ec Schelin; Patrik Ke Magnusson; Karin E Smedby; Fang Fang Journal: Clin Epidemiol Date: 2019-12-02 Impact factor: 4.790
Authors: Diego Sadler; Anita Arnold; Joerg Herrmann; Andres Daniele; Carolina Maria Pinto Domingues Carvalho Silva; Arjun K Ghosh; Sebastian Szmit; Roohi Ismail Khan; Luis Raez; Anne Blaes; Sherry-Ann Brown Journal: Curr Oncol Rep Date: 2021-04-14 Impact factor: 5.075
Authors: Lisa M Tilemann; Markus B Heckmann; Hugo A Katus; Lorenz H Lehmann; Oliver J Müller Journal: Clin Res Cardiol Date: 2018-02-16 Impact factor: 5.460