RT Journal Article
T1 Doxorubicin and subsequent risk of cardiovascular diseases among survivors of diffuse large B-cell lymphoma in Hong Kong.
A1 Lee, Shing Fung
A1 Luque-Fernandez, Miguel Angel
A1 Chen, Yu Hui
A1 Catalano, Paul J
A1 Chiang, Chi Leung
A1 Wan, Eric Yuk-Fai
A1 Wong, Ian Chi-Kei
A1 Chen, Ming Hui
A1 Ng, Andrea K
K1 Survivors
K1 Cardiovascular Diseases
K1 Doxorubicin
K1 Lymphoma, Large B-Cell, Diffuse
AB Evidence regarding the dose-related impact of doxorubicin on subsequent cardiovascular diseases (CVDs) in Asian patients with diffuse large B-cell lymphoma (DLBCL) without preexisting CVDs is lacking. From a territory-wide electronic database in Hong Kong, we identified adults who were diagnosed with DLBCL and treated with chemotherapy between 2000 and 2018. We evaluated the patients for incident CVDs (including ischemic heart disease, heart failure, and cardiomyopathy). We evaluated the cause-specific cumulative incidence (csCI) of CVD with levels of doxorubicin exposure by using flexible parametric competing risk analysis and adjusting for demographics, comorbidities, therapeutic exposure, cardiovascular risk factors, and lifestyle factors. Controls were age- and sex-matched to DLBCL patients. We analyzed 2600 patients and 13 000 controls. The adjusted cause-specific hazard ratio (HR) for CVD in patients treated with >500 mg doxorubicin compared with non-doxorubicin regimens was 2.65 (95% confidence interval [CI], 1.23-5.74; P = .013). The 5-, 10-, and 15-year csCIs were 8.2%, 11.3%, and 12.8% in patients vs 3.1%, 4.4%, and 5.2% in controls, respectively. Hypertension (HR, 6.20; 95% CI, 0.79-48.44; P = .082) and use of aspirin/angiotensin-converting enzyme inhibitor/beta-blocker at baseline (HR, 2.13-4.63; P 500 mg doxorubicin compared with non-doxorubicin regimens was 2.65 (95% confidence interval [CI], 1.23-5.74; P = .013). The 5-, 10-, and 15-year csCIs were 8.2%, 11.3%, and 12.8% in patients vs 3.1%, 4.4%, and 5.2% in controls, respectively. Hypertension (HR, 6.20; 95% CI, 0.79-48.44; P = .082) and use of aspirin/angiotensin-converting enzyme inhibitor/beta-blocker at baseline (HR, 2.13-4.63; P 500 mg), together with hypertension or baseline use of medication for cardiovascular risk factors, was found to be associated with an increase in csCIs of CVDs. Tailoring therapeutic strategies to underlying CVD risk factors and risk-adapted monitoring and follow-up of susceptible DLBCL patients are advisable.
PB American Society of Hematology
YR 2020
FD 2020-09-09
LK http://hdl.handle.net/10668/16460
UL http://hdl.handle.net/10668/16460
LA en
NO Lee SF, Luque-Fernandez MA, Chen YH, Catalano PJ, Chiang CL, Wan EY,  et all. Doxorubicin and subsequent risk of cardiovascular diseases among survivors of diffuse large B-cell lymphoma in Hong Kong. Blood Adv. 2020 Oct 27;4(20):5107-5117.
NO The authors thank K.F. Tsang (Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong) for clerical support and data retrieval. This work was supported by a grant from National Institutes of Health (NIH), Harvard Catalyst, The Harvard Clinical and Translational Science Center (National Center for Advancing Translational Sciences) (UL 1TR002541) and by Harvard University and its affiliated academic health care centers. M.A.L.-F. was supported by a Spanish National Health Institute Carlos III Miguel Servet-I Investigator grant/ award (CP17/00206-EU-FEDER). M.H.C. was supported by a grant from the NIH, National Cancer Institute (R01 CA196854). The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University and its affiliated academic health care centers, or the NIH.The funders had no role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.
DS RISalud
RD Apr 9, 2025