Cardiovascular outcomes of patients treated for non-Hodgkin lymphoma with first-line doxorubicin-based chemotherapy

Leuk Lymphoma. 2022 Dec;63(14):3340-3350. doi: 10.1080/10428194.2022.2123222. Epub 2022 Sep 18.

Abstract

We conducted a single-center retrospective study to assess cardiovascular (CV) toxicity and treatment discontinuation for CV toxicity in diffuse large B-cell lymphoma (DLBCL) or follicular lymphoma (FL) patients treated with immunochemotherapy (R-CHOP-like). Between 2006 and 2017, 433 patients were included (DLBCL: n = 345, FL: n = 88). The median age was 63 years (50-73). We defined three types of CV toxicity: early-onset cardiovascular toxicity (the event occurred within 6 months following treatment start); subacute toxicity (the event occurred between 6 months and 1 year after treatment start) and late toxicity (the event occurred 1 year or more after treatment start). Forty-eight (11.1%) patients experienced at least one anthracycline-related CV event. Seven patients experienced treatment discontinuation due to CV toxicity. Early-onset and subacute cardiac events were primarily acute heart failure (34.3%) and atrial fibrillation (28.6%). History of ischemic heart disease (p = 0.02) and valvular heart disease (p = 0.03) were associated with a higher risk of anthracycline-related CV event occurrence.

Keywords: Cardiovascular toxicity; DLBCL; R-CHOP; doxorubicin; doxorubicin-induced cardiotoxicity; immunochemotherapy; lymphoma.

MeSH terms

  • Anthracyclines
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Cyclophosphamide / therapeutic use
  • Doxorubicin / therapeutic use
  • Humans
  • Lymphoma, Follicular* / drug therapy
  • Lymphoma, Large B-Cell, Diffuse* / drug therapy
  • Lymphoma, Non-Hodgkin* / drug therapy
  • Middle Aged
  • Prednisone / therapeutic use
  • Retrospective Studies
  • Rituximab
  • Vincristine / therapeutic use

Substances

  • Doxorubicin
  • Rituximab
  • Vincristine
  • Cyclophosphamide
  • Prednisone
  • Anthracyclines