WHAT IS KNOWN AND OBJECTIVE: The CHOP regimen with rituximab (R-CHOP) remains the standard for chemotherapy in patients with aggressive non-Hodgkin's lymphoma (NHL). The cardiotoxicity of doxorubicin appears to be a key problem in clinical practice. We studied the cardiotoxicity of CHOP/R-CHOP regimen in a retrospective series. The prognostic factors of congestive heart failure (CHF) were investigated, including the impact of empirical cardioprotection by dexrazoxane. METHODS: Patients with an aggressive NHL between 1994 and 2005 were included. Cardiac events were defined as either a decline in resting left ventricular ejection fraction (LVEF) <50%, a decline in LVEF of ≥20% from baseline or as clinical evidence of CHF. The risk of cardiotoxicity was explored by the Kaplan-Meier method. RESULTS: The study included 180 consecutive patients. During the second period of the survey, cardioprotective therapy by dexrazoxane was administered to 45% of patients. The 5-year cumulative risks of cardiac events (29% vs. 8%) and clinical CHF (17% vs. 1·5%) varied significantly between the two periods of study (1994-2000 vs. 2001-2005). In multivariate analysis, use of dexrazoxane (HR = 0·1 [0·01-0·75], P = 0·02) and age < 60 years (HR = 0·4 [0·17-0·9], P = 0·03) appeared as protective factors of cardiac events. WHAT IS NEW AND CONCLUSION: Our study confirmed the weight of cardiac toxic effect of CHOP ± R regimen. Even if the use of dexrazoxane is highly debatable in curative situations, it may be an effective prevention of cardiotoxicity in aggressive NHL patients.
WHAT IS KNOWN AND OBJECTIVE: The CHOP regimen with rituximab (R-CHOP) remains the standard for chemotherapy in patients with aggressive non-Hodgkin's lymphoma (NHL). The cardiotoxicity of doxorubicin appears to be a key problem in clinical practice. We studied the cardiotoxicity of CHOP/R-CHOP regimen in a retrospective series. The prognostic factors of congestive heart failure (CHF) were investigated, including the impact of empirical cardioprotection by dexrazoxane. METHODS:Patients with an aggressive NHL between 1994 and 2005 were included. Cardiac events were defined as either a decline in resting left ventricular ejection fraction (LVEF) <50%, a decline in LVEF of ≥20% from baseline or as clinical evidence of CHF. The risk of cardiotoxicity was explored by the Kaplan-Meier method. RESULTS: The study included 180 consecutive patients. During the second period of the survey, cardioprotective therapy by dexrazoxane was administered to 45% of patients. The 5-year cumulative risks of cardiac events (29% vs. 8%) and clinical CHF (17% vs. 1·5%) varied significantly between the two periods of study (1994-2000 vs. 2001-2005). In multivariate analysis, use of dexrazoxane (HR = 0·1 [0·01-0·75], P = 0·02) and age < 60 years (HR = 0·4 [0·17-0·9], P = 0·03) appeared as protective factors of cardiac events. WHAT IS NEW AND CONCLUSION: Our study confirmed the weight of cardiac toxic effect of CHOP ± R regimen. Even if the use of dexrazoxane is highly debatable in curative situations, it may be an effective prevention of cardiotoxicity in aggressive NHL patients.
Authors: Solomon Kibudde; Charles Kiiza Mondo; Davis Kibirige; Victoria Walusansa; Jackson Orem Journal: Afr Health Sci Date: 2019-03 Impact factor: 0.927
Authors: Derek W Edwardson; Rashmi Narendrula; Simon Chewchuk; Kyle Mispel-Beyer; Jonathan P J Mapletoft; Amadeo M Parissenti Journal: Curr Drug Metab Date: 2015 Impact factor: 3.731
Authors: Giorgio Berlot; Giulia Moratelli; Martina Tarchini; Katiuscia Battaglia; Paolo Grassi; Nadia Zarrillo; Vincenzo Colella; Rossana Bussani Journal: Case Rep Crit Care Date: 2019-09-10
Authors: Sarju Ganatra; Anju Nohria; Sachin Shah; John D Groarke; Ajay Sharma; David Venesy; Richard Patten; Krishna Gunturu; Corrine Zarwan; Tomas G Neilan; Ana Barac; Salim S Hayek; Sourbha Dani; Shantanu Solanki; Syed Saad Mahmood; Steven E Lipshultz Journal: Cardiooncology Date: 2019-01-29
Authors: Rajeev Masson; Lina Titievsky; Douglas A Corley; Wei Zhao; Alfredo R Lopez; Jennifer Schneider; Jonathan G Zaroff Journal: Cancer Med Date: 2019-10-30 Impact factor: 4.452