Incidence and risk‐factors of CHOP/R‐CHOP‐related cardiotoxicity in patients with aggressive non‐Hodgkin's lymphoma. (3rd January 2014)

• Record Type: Journal Article
• Authors: Limat, S.; Daguindau, E.; Cahn, J.‐Y.; Nerich, V.; Brion, A.; Perrin, S.; Woronoff‐Lemsi, M.‐C.; Deconinck, E.
• Is Part Of: Journal of clinical pharmacy and therapeutics. Volume 39:Number 2(2014:Apr.)
• Page Start: 168
• Page End: 174
• Publication Date: 2014-01-03
• Subjects: Clinical pharmacology -- Periodicals; Chemotherapy -- Periodicals; 615
• DOI: 10.1111/jcpt.12124
• Languages: English
• ISSNs: 0269-4727

Abstract

<abstract abstract-type="main" id="jcpt12124-abs-0001"> <title>Summary</title> <sec id="jcpt12124-sec-0001" sec-type="section"> <title>What is known and objective</title> <p>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.</p> </sec> <sec id="jcpt12124-sec-0002" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="jcpt12124-sec-0003" sec-type="section"> <title>Results</title> <p>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], <italic>P</italic> = 0·02) and age < 60 years (HR = 0·4 [0·17–0·9], <italic>P</italic> = 0·03) appeared as protective factors of cardiac events.</p> </sec> <sec id="jcpt12124-sec-0004" sec-type="section"> <title>What is new and conclusion</title> <p>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.</p> </sec> </abstract>