Document Detail


Early cardiotoxicity of the CHOP regimen in aggressive non-Hodgkin's lymphoma.
MedLine Citation:
PMID:  12562656     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: To determine the incidence of early cardiotoxicity induced by the CHOP regimen in patients with aggressive non-Hodgkin's lymphoma (NHL) and to identify associated risk factors. PATIENTS AND METHODS: A retrospective analysis included 135 consecutive patients who had been treated with the CHOP (cyclophosphamide, doxorubicin, vincristin, prednisone) regimen as first-line therapy between 1994 and 2000. The cardiac evaluation was based on a determination of the resting left ventricular ejection function (LVEF) by gated blood-pool imaging. Cardiotoxicity was defined as a significant decrease in LVEF or clinical evidence of congestive heart failure (CHF). RESULTS: Twenty-seven (20%) patients developed a cardiac event within 1 year of treatment. Among these, 14 patients had clinical signs of CHF. Three patients died suddenly from presumed cardiac causes. In multivariate analysis, a cumulative dose of doxorubicin >200 mg/m(2) [odds ratio (OR) = 4.2, P = 0.005)] and age over 50 years (OR = 2.9, P = 0.03) appeared to be significant risk factors. CONCLUSION: Early clinical and subclinical cardiotoxicity was frequent in patients receiving the CHOP regimen. The threshold of the cumulative dose of doxorubicin appeared to be low: at doses >200 mg/m(2), 27% of patients had cardiac events. Elderly patients appeared to be at higher risk. The development of cardioprotective strategies or alternative treatments are mandatory for aggressive NHL patients.
Authors:
S Limat; K Demesmay; L Voillat; Y Bernard; E Deconinck; A Brion; A Sabbah; M C Woronoff-Lemsi; J Y Cahn
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Annals of oncology : official journal of the European Society for Medical Oncology / ESMO     Volume:  14     ISSN:  0923-7534     ISO Abbreviation:  Ann. Oncol.     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-03     Completed Date:  2003-06-04     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9007735     Medline TA:  Ann Oncol     Country:  England    
Other Details:
Languages:  eng     Pagination:  277-81     Citation Subset:  IM    
Affiliation:
Department of Pharmacy, Besançon University Hospital, Besançon, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Age Factors
Aged
Antineoplastic Combined Chemotherapy Protocols / administration & dosage,  adverse effects*,  therapeutic use*
Cyclophosphamide / administration & dosage,  adverse effects
Dose-Response Relationship, Drug
Doxorubicin / administration & dosage,  adverse effects
Female
Heart Failure / chemically induced*
Humans
Lymphoma, Non-Hodgkin / drug therapy*,  pathology
Male
Middle Aged
Prednisone / administration & dosage,  adverse effects
Retrospective Studies
Risk Factors
Ventricular Dysfunction, Left / chemically induced*
Vincristine / administration & dosage,  adverse effects
Chemical
Reg. No./Substance:
0/CHOP protocol; 23214-92-8/Doxorubicin; 50-18-0/Cyclophosphamide; 53-03-2/Prednisone; 57-22-7/Vincristine

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