Incidence and risk-factors of CHOP/R-CHOP-related cardiotoxicity in patients with aggressive non-Hodgkin's lymphoma

Abstract

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.

2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines

“…U starszych pacjentów z uprzednio stwierdzonymi czynnikami ryzyka CV krótkoterminowe ryzyko wystąpienia HF również jest zwiększone. Na przykład, wśród pacjentów, którzy przebyli agresywnego chłoniaka nieziarniczego, 5-letnia zapadalność na jawną klinicznie HF wynosi 17% [8]. Zwiększa się również świadomość występowania dysfunkcji LV lub HF wywoły-wanej przez inhibitory kinaz tyrozynowych (TKI), zwłaszcza u pacjentów onkologicznych z uprzednio występującymi czynnikami ryzyka CV [9].…”

Role of Drug Metabolism in the Cytotoxicity and Clinical Efficacy of Anthracyclines

“…Perhaps one of the best pieces of evidence that iron plays a pivotal role in the ROS-mediated toxicity of DOX comes from numerous studies showing that the iron chelator dexrazoxane (DEX) can effectively block anthracycline cardiotoxicity [138]. It has been repeatedly shown to mitigate anthracycline toxicity, and is approved for clinical use [150-152]. Marty et al have shown in a randomized phase III study of 164 breast cancer patients that in comparison to patients receiving an anthracycline alone, patients treated with both an anthracycline and DEX experienced significantly fewer and less severe episodes of congestive heart failure, without affecting the tumor response rate [116].…”

Pixantrone: a novel anthracycline-like drug for the treatment of non-Hodgkin lymphoma

“…There again, the interval between treatment and the onset of the stroke or myocardial infarction event is relatively short (2.5 [1.8 --3.4] and 3.7 [1.6 --5.1] respectively) but they were not associated with chemotherapy [4]. Furthermore, it is currently estimated that 5% of patients treated with CHOP will sustain myocardial damage sufficient to cause chronic heart failure [6] and evidence from Hodgkin lymphoma studies would also suggest a higher prevalence of subclinical injuries that can evolve into clinical lesions [7]. Box 1.…”