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Cardiac toxicity secondary to anthracycline treatment in diffuse large B-cell lymphoma

Journal of Cardiology & Current Research
Agustin Aviles, Sergio Cleto


Background: Cardiac toxicity associated with oncology drugs, is a known risk, although multiple studies has been performed to detect this problem in an early stage, no definitive results has been achieved. We conducted a clinical study in a large number of patients with a longer follow-up, to evaluate if surveillance tests, such as 2D echocardiogram (ECHO) and radionuclide ventriculography (RNV) can detected early cardiac damage in patients who received anthracycline-based chemotherapy.

Patients and methods: We conducted a cohort clinical study in 3073 patients with pathological confirmed of diffuse large B-cell lymphoma that had a complete response with a longer follow-up: 18. (Range 6.8 to 32.3) years: the mentioned test were performed periodically: every 6months the first 5years, an annually from 5years until relapse, death from any cause or last of follow-up, or the presence of congestive heart failure.

Results: Asymptomatic abnormalities in surveillance studies, without clinical and radiological evidence of cardiac damage were observed in 58 cases (1.21%); none of these patients developed clinical evidence of cardiac damage; and eight patients developed clinical and radiology evident changes of heart failure, neither of they showed previous abnormalities in surveillance studies. Multivariate analysis did not show any statistically difference, even in patients whose received > 450mg/m2.

Conclusion: The use of surveillance studies did not predict early cardiac damage and will not be used as surveillance tests. Now resources will be developed, because the risk of cardiac damage secondary to anthracyclines remains constant.


RNV, radionuclide ventriculography, ECHO, radionuclide ventriculography, RNV, radionuclide ventriculography, LVVF, left ejection ventricular fraction, CHF, congestive hearts failure