Key result
Among 50 hematology-oncology providers, 30% would use non-anthracycline regimens for a DLBCL patient with LVEF 40-45%, showing substantial variability in preferred treatment regimens.
Cross-Sectional (n=50)
Yes
There is substantial variability among hematology-oncology providers in the management and cardiac monitoring of lymphoma patients with preexisting cardiomyopathy or high cumulative anthracycline exposure.
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Variability signals inconsistent cardio-oncology care in lymphoma; leaves open whether standardization improves outcomes.
The optimal treatment of patients with diffuse large B-cell lymphoma (DLBCL) or Hodgkin lymphoma (HL) with preexisting cardiomyopathy is uncertain. An anonymous, electronic survey was distributed by e-mail to three US lymphoma cooperative groups, two community hospitals, and twelve academic medical systems, and distributed at one international lymphoma meeting. Fifty hematology-oncology providers caring for patients with lymphoma were included. In response to a vignette of a 67-yo with Stage III DLBCL with LVEF of 40–45%, 15 (30%) would use non-anthracycline regimens, 13 (26%) R-CHOP with liposomal doxorubicin instead of doxorubicin, 11 (22%) R-CHOP without modification and 6 (12%) R-CHOP with a continuous doxorubicin infusion. In a second vignette of a patient with HL in remission after frontline treatment with doxorubicin cumulative dose 300 mg/m2, 16 (32%) would order an echocardiogram after treatment. There was substantial variability in preferred treatment regimens with preexisting cardiomyopathy and in cardiac monitoring after anthracycline.
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Anderson et al. (2025) conducted a cross-sectional in Hematology-oncology providers caring for patients with lymphoma (n=50). Clinical vignettes regarding lymphoma treatment with preexisting cardiomyopathy was evaluated on Preferred treatment regimens and cardiac monitoring strategies. Among 50 hematology-oncology providers, 30% would use non-anthracycline regimens for a DLBCL patient with LVEF 40-45%, showing substantial variability in preferred treatment regimens.
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