Decreased left ventricular ejection fraction in post treatment non-Hodgkin’s lymphoma patients receiving CHOP-based regimen
Keywords:
Chemotherapy, Doxorubicin, CHOP-based regimen, Cardiomyopathy, Non Hodgkin lymphomaAbstract
Background: Cardiomyopathy, defined as the reduction of left ventricular ejection fraction (LVEF), is a well-known adverse effect of CHOP-based regimen chemotherapy. Therefore, this research aims to determine the prevalence of cardiomyopathy in lymphoma patients after CHOP-based regimen in Udon Thani Hospital. Materials and methods: This retrospective descriptive study included adult patients with lymphoma who finished standard CHOP based chemotherapy. Patients’ data were collected using questionnaires, physical examination, EKG, chest X-ray, and echocardiography. Cardiomyopathy was defined as followed: (1) post-chemotherapy LVEF< 55% or (2) the reduction of post treatment LVEF > 10% as compared to pretreatment value. The results were analyzed by descriptive and analytical statistics. Statistical significance was determined by p < 0.05%. Results: Of 67 participants, 31 (46.27%) were men, and the mean age was 59.97 ± 10.36 years. There were 25 patients (37.31%) obtaining pre-chemotherapy echocardiography. Thirty five patients (52.24%) received 8 cycles of CHOP based regimen, and the mean doxorubicin cumulative dose was 358.2 mg/m2. The mean post-chemotherapy LVEF value was 63.8 ± 8.93%. Notably, cardiomyopathy was documented in 15 (22.3%) patients. Of the 15 patients with cardiomyopathy, 6 had post-chemotherapy LVEF <55%, while 9 had decreased LVEF > 10% compared to pretreatment values. Factors correlated with the post chemotherapy cardiomyopathy were 8-CHOP based cycle regimen, doxorubัicin cumulative dose > 350 mg/m2. Summary: The prevalence of post-chemotherapy cardiomyopathy was 22.3%. We suggest that every patient treated with CHOP based regimen should obtain cardiac function assessment with echocardiography before initiation of treatment.
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