Cardiovascular disease risks in younger versus older adult B‐cell non‐Hodgkin’s lymphoma survivors

Ocier, Krista; Abdelaziz, Sarah; Kim, Seungmin; Rowe, Kerry; Snyder, John; Deshmukh, Vikrant; Newman, Michael G.; Fraser, Alison; Smith, Ken R.; Porucznik, Christina A.; Shoaf, Kimberley; Stanford, Joseph B.; Lee, Catherine J.; Hashibe, Mia

doi:10.1002/cam4.3934

Cited by 5 publications

(1 citation statement)

References 30 publications

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“…In child, adolescent, and adult DLBCL survivors, CVM might be related to disease stages, treatment modalities, and genetic factors ( 6 , 7 , 11 ). The challenges in estimating CVM risks have been highlighted in previous studies ( 5 , 7 , 12 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

Development and validation of a nomogram for predicting cardiovascular mortality risk for diffuse large B-cell lymphoma in children, adolescents, and adults

Mu,

Zhang,

et al. 2024

Front. Pediatr.

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ObjectiveThis study aimed to construct and validate a nomogram for predicting cardiovascular mortality (CVM) for child, adolescent, and adult patients with diffuse large B-cell lymphoma (DLBCL).Materials and methodsPatients with only one primary tumor of DLBCL first diagnosed between 2000 and 2019 in the SEER database were extracted. We used the cumulative incidence function (CIF) to evaluate the cumulative rate of CVM. The outcome of interest was CVM, which was analyzed using a competing risk model, accounting for death due to other causes. The total database was randomly divided into a training cohort and an internal validation cohort at a ratio of 7:3. Adjustments were for demographics, tumor characteristics, and treatment modalities. Nomograms were constructed according to these risk factors to predict CVM risk at 5, 10, and 15 years. Validation included receiver operating characteristic (ROC) curves, time-dependent ROC, C-index, calibration curves, and decision curve analysis.ResultsOne hundred four thousand six hundred six patients following initial diagnosis of DLBCL were included (58.3% male, median age 64 years, range 0–80, White 83.98%). Among them, 5.02% died of CVM, with a median follow-up time of 61 (31–98) months. Nomograms based on the seven risk factors (age at diagnosis, gender, race, tumor grade, Ann Arbor stage, radiation, chemotherapy) with hazard ratios ranging from 0.19–1.17 showed excellent discrimination, and calibration plots demonstrated satisfactory prediction. The 5-, 10-, and 15-year AUC and C-index of CVM in the training set were 0.716 (0.714–0.718), 0.713 (0.711–0.715), 0.706 (0.704–0.708), 0.731, 0.727, and 0.719; the corresponding figures for the validation set were 0.705 (0.688–0.722), 0.704 (0.689–0.718), 0.707 (0.693–0.722), 0.698, 0.698, and 0.699. Decision curve analysis revealed a clinically beneficial net benefit.ConclusionsWe first built the nomogram model for DLBCL patients with satisfactory prediction and excellent discrimination, which might play an essential role in helping physicians enact better treatment strategies at the time of initial diagnosis.

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Section: Introductionmentioning

confidence: 99%

Development and validation of a nomogram for predicting cardiovascular mortality risk for diffuse large B-cell lymphoma in children, adolescents, and adults

Mu,

Zhang,

et al. 2024

Front. Pediatr.

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Contributions of cancer treatment, comorbidities, and obesity to aging-related disease risks among non-Hodgkin lymphoma survivors

Ocier

Abdelaziz

Kim

et al. 2022

Cancer Causes Control

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Long-term risk of heart failure in adult cancer survivors: a systematic review and meta-analysis

Wong,

Soh,

Wang

et al. 2024

Heart

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BackgroundCancer survivors are at increased risk of heart failure (HF). While cardiotoxicity is commonly sought at the time of cancer chemotherapy, HF develops as a result of multiple ‘hits’ over time, and there is limited evidence regarding the frequency and causes of HF during survivorship.ObjectivesThis systematic review sought to investigate the relationship between cardiotoxic cancer therapies and HF during survivorship.MethodsWe searched the EMBASE, MEDLINE and CINAHL databases for studies reporting HF in adult survivors (≥50 years old), who were ≥5 years postpotential cardiotoxic cancer therapy. A random effects model was used to examine the associations of HF.ResultsThirteen papers were included, comprising 190 259 participants (mean age 53.5 years, 93% women). The risk of HF was increased (overall RR 1.47 (95% CI (1.17 to 1.86)). Cardiotoxic treatment, compared with cancer alone, provided a similar risk (RR of 1.46 (95% CI 0.98 to 2.16)). The overall HF incidence rate was 2.1% compared with 1.7% in the control arm—an absolute risk difference of 0.4%. In the breast cancer population ratio (11 studies), the overall HF RR was 2.57 (95% CI 1.35 to 4.90)). Although heterogeneity was significant (I2=77.2), this was explained by differences in patient characteristics; once multivariable analysis accounted for follow-up duration (OR 0.99, 95% CI (0.97 to 0.99), p=0.047), age (OR 1.14, 95% CI (1.04 to 1.25), p=0.003) and hypertension (OR 0.95, 95% CI (0.92 to 0.98), p<0.001), residual heterogeneity was low (I2=28.7).ConclusionsHF is increased in adult cancer survivors, associated with cardiotoxic cancer therapy and standard risk factors. However, the small absolute risk difference between survivors and controls suggests that universal screening of survivors is unjustifiable. A risk model based on age, cardiotoxic cancer therapy and standard risk factors may facilitate a selective screening process in this at-risk population.

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Cardiovascular disease risks in younger versus older adult B‐cell non‐Hodgkin’s lymphoma survivors

Abstract: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Cited by 5 publications

References 30 publications

Development and validation of a nomogram for predicting cardiovascular mortality risk for diffuse large B-cell lymphoma in children, adolescents, and adults

Development and validation of a nomogram for predicting cardiovascular mortality risk for diffuse large B-cell lymphoma in children, adolescents, and adults

Contributions of cancer treatment, comorbidities, and obesity to aging-related disease risks among non-Hodgkin lymphoma survivors

Long-term risk of heart failure in adult cancer survivors: a systematic review and meta-analysis

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