Anthracycline-induced cardiotoxicity in diffuse large B-cell lymphoma: NT-proBNP and cardiovascular score for risk stratification.

Autor: Ferraro MP; Department of Hematology, Hospital del Mar, Barcelona, Spain.; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.; Clinical Hematology Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain., Gimeno-Vazquez E; Department of Hematology, Hospital del Mar, Barcelona, Spain.; Clinical Hematology Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain., Subirana I; CIBER of Epidemiology and Public Health, Barcelona, Spain.; Cardiovascular Epidemiology and Genetics Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain., Gómez M; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.; Department of Cardiology, Hospital del Mar, Barcelona, Spain.; Heart Diseases Biomedical Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain., Díaz J; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain., Sánchez-González B; Department of Hematology, Hospital del Mar, Barcelona, Spain.; Clinical Hematology Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain., García-Pallarols F; Department of Hematology, Hospital del Mar, Barcelona, Spain.; Clinical Hematology Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain., Martínez L; Department of Hematology, Hospital del Mar, Barcelona, Spain., Ble M; Department of Cardiology, Hospital del Mar, Barcelona, Spain., Molina L; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.; Department of Cardiology, Hospital del Mar, Barcelona, Spain.; Heart Diseases Biomedical Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain., Belarte LC; Department of Cardiology, Hospital del Mar, Barcelona, Spain., Abella E; Department of Hematology, Hospital del Mar, Barcelona, Spain.; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.; Clinical Hematology Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain., Elosua R; Cardiovascular Epidemiology and Genetics Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.; CIBER of Cardiovascular Disorders, Barcelona, Spain., Comín-Colet J; Department of Cardiology, Hospital del Mar, Barcelona, Spain.; Heart Diseases Biomedical Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.; Cardiovascular Research Group, Bellvitge Biomedical Research Institute, Hospitalet, Barcelona, Spain., Salar A; Department of Hematology, Hospital del Mar, Barcelona, Spain.; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.; Clinical Hematology Research Group, Hospital del Mar Medical Research Institute, Barcelona, Spain.
Jazyk: angličtina
Zdroj: European journal of haematology [Eur J Haematol] 2019 Jun; Vol. 102 (6), pp. 509-515. Date of Electronic Publication: 2019 Apr 23.
DOI: 10.1111/ejh.13234
Abstrakt: Objective: To evaluate the role of N-terminal pro-brain-type natriuretic peptide (NT-proBNP) and a cardiovascular (CV) risk score named FRESCO for predicting anthracycline-induced cardiotoxicity (AIC) in diffuse large B-cell lymphoma (DLBCL).
Methods: A total of 130 consecutive DLBCL patients treated in first-line with anthracycline-containing immunochemotherapy. Competitive risk between NT-proBNP, FRESCO, and time to AIC was considered.
Results: Cumulative incidence of AIC was 12.2% and 17.5% at 1 and 5 years, respectively. Median time to development cardiotoxicity was 6.4 months, with half of the cases showing heart failure and the other half silent AIC. Both NT-proBNP levels and FRESCO score were independently associated with higher risk of AIC (P = 0.001 and P = 0.03, respectively). Patients with NT-proBNP ≥600 pg/mL or those with FRESCO ≥4.5% had 3.97 or 2.54 times higher risk of AIC than those with lower values (P = 0.001 and P = 0.048, respectively). According to the previous cutoffs, three groups of patients with a significantly different risk of AIC could be identified (P < 0.0001).
Conclusions: Doxorubicin-containing chemotherapy is associated with increased risk of silent and overt AIC. Baseline NT-proBNP levels and FRESCO CV risk score are accurate predictors of AIC and can identify groups of patients at different risk, in which personalized cardiologic evaluation should be offered.
(© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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