The effects of cardiovascular disease on the clinical outcome of elderly patients with diffuse large B-cell lymphoma

被引：16

作者：

Tsai, Huei-Ting ^{[1
]}

Pfeiffer, Ruth M. ^{[1
]}

Warren, Joan ^{[2
]}

Wilson, Wyndham ^{[3
]}

Landgren, Ola ^{[3
,4
]}

机构：

[1] NCI, Biostat Branch, Div Canc Epidemiol & Genet, Ctr Canc Res,NIH, Bethesda, MD 20892 USA

[2] NCI, Div Canc Control & Populat Sci, Ctr Canc Res, NIH, Bethesda, MD 20892 USA

[3] NCI, Metab Branch, Ctr Canc Res, NIH, Bethesda, MD 20892 USA

[4] Mem Sloan Kettering Canc Ctr, Dept Med, Myeloma Serv, New York, NY 10065 USA

来源：

LEUKEMIA & LYMPHOMA | 2015年 / 56卷 / 03期

关键词：

Cardiovascular disease; doxorubicin; rituximab; elderly cardiac failure; prognosis; survival; outcome; NON-HODGKINS-LYMPHOMA; SEER-MEDICARE DATA; RISK-FACTORS; PHASE-II; DOXORUBICIN; CHEMOTHERAPY; RITUXIMAB; EPOCH; CARDIOMYOPATHY; MULTICENTER;

D O I：

10.3109/10428194.2014.921914

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

We identified 3910 elderly (>65 yrs) patients with diffuse large B-cell lymphoma (DLBCL) who received doxorubicin-based (+/-rituximab) therapy and 77 347 cancer-free controls, and assessed cardiovascular events and survival in relation to preexisting cardiovascular comorbidities. Compared to controls, patients with DLBCL had a 3.4-fold (95% CI 3.0-3.9) and 2.5-fold (95% CI 2.3-2.7) increased risk of congestive heart failure (CHF)/cardiomyopathy (CM) within 6 months and 3 years of diagnosis, respectively. Risk of acute myocardial infarction (AMI) was similarly increased. The risk of CHF/CM and AMI was significantly higher in those patients with DLBCL (vs. controls) who did not report preexisting cardiovascular disease, compared to those who had preexisting cardiovascular disease; this was due to dose reductions of doxorubicin among patients with preexisting cardiovascular disease. Rituximab improved survival in patients with stage III-IV (but not I-II) disease (p-interaction=0.0003). Our novel findings emphasize the need to reduce cardiac toxicity of doxorubicin in elderly DLBCL patients.

引用

页码：682 / 687

页数：6

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