Concordance analysis between practice and algorithm recommendations for cardiac screening in a cohort of high-risk lymphoma survivors.

Authors

null

Whittney S. Thoman

The University of Texas MD Anderson Cancer Center, Houston, TX

Whittney S. Thoman, Katherine Ramsey Gilmore, Patricia Hansberry Chapman, Weiqi Bi, Haleigh Mistry, Ellen Mullen, Anita Deswal, Ihab Hamzeh, Maria Alma Rodriguez

Organizations

The University of Texas MD Anderson Cancer Center, Houston, TX, Department of Lymphoma/Myeloma, The University of Texas MD Anderson Cancer Center, Houston, TX

Research Funding

No funding received
None.

Background: Cardiovascular disease (CVD) is a leading cause of mortality among cancer survivors, with the risk peaking five or more years post-diagnosis. Among survivors, lymphoma patients receiving cardio-toxic therapies such as anthracyclines and mediastinal radiation exhibit an elevated risk for CVD-related complications and mortality. To address this concern, we have implemented lymphoma survivorship care algorithms that outline recommended cardiovascular health monitoring for these patients. Methods: In 2021, 387 patients were seen in the Lymphoma Survivorship clinic. Of these, 53 were previously treated with both an anthracycline and thoracic radiation. We conducted a review of cardiac screening tests and visits for this high-risk group, with the aim of evaluating the concordance between their survivorship care and the algorithm recommendations. Specifically, we assessed the frequency and type of cardiac screening received by these patients at risk for cardiac late effects from treatment, and the prevalence of cardiac abnormalities in the cohort. Results: The mean age of the patients at their most recent survivorship appointment was 53 years, while the median time since the last radiation therapy was 11.67 years. Of the patients studied, 84.9% had a post-treatment cardiology consultation, with 69.8% receiving cardiology services at MD Anderson. An echocardiogram (ECHO) was available for 90.5% of patients, with no abnormal left ventricular ejection fraction (LVEF) reported. The average number of cardiology visits was 3.08 per patient, and the average time between the most recent ECHO and the latest survivorship appointment was 1.26 years. A lipid profile was performed for 98% of the cohort, typically during their survivorship appointment or a subsequent cardiology visit. Body Mass Index (BMI) and blood pressure were assessed in all patients, with an average BMI of 29 and hypertension reported in 28% of cases. Conclusions: We identified a high level of concordance in survivorship care and our algorithm’s recommendations for a cohort of lymphoma survivors with a high risk of cardiovascular late effects post-treatment. We conclude the algorithm was beneficial in guiding care in this patient population. Collaboration with cardiology services is crucial for identifying and monitoring high-risk survivors, updating cardiology care guidelines, and continuously monitoring long-term cardiovascular outcomes.

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Abstract Details

Meeting

2023 ASCO Quality Care Symposium

Session Type

Poster Session

Session Title

Poster Session A

Track

Quality, Safety, and Implementation Science,Cost, Value, and Policy,Patient Experience,Survivorship

Sub Track

Late- and Long-Term Effects/Comorbidities

Citation

JCO Oncol Pract 19, 2023 (suppl 11; abstr 498)

DOI

10.1200/OP.2023.19.11_suppl.498

Abstract #

498

Poster Bd #

L24

Abstract Disclosures

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