scholarly journals Summed rest score in gated myocardial perfusion imaging is a good predicator for treatment-related cardiotoxicity after anthracycline chemotherapy in diffuse large B-cell lymphoma patients

2020 ◽  
Author(s):  
Yan Lin ◽  
Jianfeng Wang ◽  
Min Xu ◽  
Chun Qiu ◽  
Peng Xu ◽  
...  

Abstract Background: Anthracycline chemotherapy is commonly used in the treatment of diffuse large B-cell lymphoma (DLBCL) patients. Treatment-related cardiotoxicity (TRC) may be observed during treatment and may induce severe cardiac failure or cardiac arrhythmia as the main cause of death, even several years after chemotherapy implementation. Herein, we performed a study to investigate the prognostic value of gated myocardial perfusion imaging (G-MPI) summed rest score (SRS) for the early detection of TRC caused by anthracycline chemotherapy in DLBCL patients.Methods: A total of 36 DLBCL patients were enrolled, and a series of parameters from the same individual patient were compared between baseline and after the end of the 6th R-CHOP chemotherapeutic regimen. According to whether TRC occurred during the observation period, the patients were divided into two groups, and parameters related to cardiac function were compared.Results: SRS in G-MPI and QTc interval in electrocardiogram were significantly different before and after chemotherapy (P = 0.012 and P = 0.015, respectively).By comparing parameters related to cardiac function between the TRC group (n = 22) and the no-TRC group (n = 14), only SRS was significantly different (P = 0.012). Multivariate logistic regression analysis showed that the SRS level was the only independent predicator for TRC (P = 0.018, HR = 6.053, 95% CI: 1.364-26.869). Receiver operating characteristic curve analysis identified an optimal SRS cutoff of >1for predicting TRC after anthracycline chemotherapy (P< 0.001).Conclusion: The G-MPI SRS level was an early indicator for TRC surveillance in DLBCL patients after anthracycline chemotherapy, thus contributing to early treatment and a subsequent decrease in mortality caused by such cardiovascular complications.

Praxis ◽  
2016 ◽  
Vol 105 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Andreas Lohri

Zusammenfassung. Maligne Lymphome unterteilen sich zwar in über 60 Entitäten, das grosszellige B-Zell-Lymphom, das follikuläre Lymphom, der Hodgkin und das Mantelzell-Lymphom machen aber mehr als die Hälfte aller Lymphome aus. Im revidierten Ann Arbor staging system gelten die Suffixe «A» und «B» nur noch für den Hodgkin. «E» erscheint nur noch bei Stadien I und II. Eine Knochenmarksuntersuchung wird beim Hodgkin nicht mehr verlangt, beim DLBCL (Diffuse large B cell lymphoma) nur, falls das PET keinen Knochenmark-Befall zeigt. Der PET-Untersuchung, speziell dem Interim-PET, kommt eine entscheidende Bedeutung zu. PET-gesteuerte Therapien führen zu weniger Toxizität. Gezielt wirkende Medikamente mit eindrücklicher Wirksamkeit wurden neu zugelassen. Deren Kosten sind hoch. Eine strahlen- und chemotherapiefreie Behandlung maligner Lymphome wird in Zukunft möglich sein.


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