Anthracycline-related cardiotoxicity among patients with lymphoma: Systematic review and meta-analysis.

Authors

null

Anan Abdelmoti Abu Rmilah

Mayo Clinic, Rochester, MN

Anan Abdelmoti Abu Rmilah , Vidur Kailash , Naba Farooqui , Sae Jang , Kathryn Jean Ruddy , Saro Armenian , Daniel John Lenihan , Charles L. Loprinzi , Joerg Herrmann

Organizations

Mayo Clinic, Rochester, MN, Mayo Clinic-Rochester, Rochester, MN, City of Hope, Duarte, CA, Saint Francis Healthcare System of Hawaii, Cape Girardeau, MO

Research Funding

U.S. National Institutes of Health
U.S. National Institutes of Health

Background: Anthracycline-induced cardiotoxicity (AIC) is a well-known phenomenon, but event rates and predictors may not be as robust as commonly perceived. We performed a systematic review and meta-analysis to elucidate AIC definitions, incidence rates and predictors. Methods: 5323 reports were identified via searching Medline, Embase, and Scopus. Inclusion criteria for full text review included minimum of 100 lymphoma patients receiving ACs; median/mean follow up of at least 12 months; and specified evaluation of left ventricular ejection fraction. We investigated the definition, reported incidence, and predictors of AIC including subclinical AIC as detected by decrease in left ventricular systolic dysfunction. Meta-analysis was performed with Meta-analyst software with random effects model. Results: A total of 19 studies were included in the analysis. The overall incidence of AIC in 13926 patients was 13.8% (95% CI 4.8-22.8, I299.6% p < 0.001) at a mean/median follow-up ranging from 1 to 8 years. Subclinical AIC was seen in 8.2% of 5464 patients (95% CI 6.4 to 10%, I278.9%, p < 0.001) at a mean/median follow-up ranging from 1 to 20 years. Subclinical AIC is defined in most studies as asymptomatic decrease in LVEF by 10-15% from baseline of 50-55%. Older age, increasing AC dose or number of cycles, GLS (global longitudinal strain), and prior comorbidities such as CAD, HTN, DM and dyslipidemia were found to predict AIC. However, Heterogeneity was seen in definition of AIC, risk factor assessment and follow-up protocol, which limited the extent of correlative analyses for cardiotoxicity predictors. Conclusions: The overall incidence of clinical HF and subclinical AIC among lymphoma patients was 13.8% and 8.2% respectively. Older age, increasing AC dose or number of cycles, GLS, and prior comorbidities such as CAD, HTN, DM and dyslipidemia were found to predict AIC.

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Abstract Details

Meeting

2023 ASCO Annual Meeting

Session Type

Publication Only

Session Title

Publication Only: Hematologic Malignancies—Lymphoma and Chronic Lymphocytic Leukemia

Track

Hematologic Malignancies

Sub Track

Hodgkin Lymphoma

Citation

J Clin Oncol 41, 2023 (suppl 16; abstr e19517)

DOI

10.1200/JCO.2023.41.16_suppl.e19517

Abstract #

e19517

Abstract Disclosures

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