Lymphoma survivors treated with autologous stem-cell transplantation had a significantly higher risk of left ventricular systolic dysfunction than matched controls (OR 6.6; 95% CI 2.5-17.6; P<0.001).
Cross-Sectional (n=274)
Yes
Does prior treatment with auto-HCT for lymphoma increase the risk of left ventricular systolic dysfunction compared to matched controls?
Adult lymphoma survivors treated with auto-HCT have a significantly increased risk of left ventricular systolic dysfunction and heart failure compared to matched controls, driven by doxorubicin and cardiac radiation doses.
Effect estimate: OR 6.6 (95% CI 2.5-17.6)
p-value: p=<0.001
PURPOSE: We aimed to determine the prevalence of left ventricular systolic dysfunction (LVSD), including symptomatic (ie, heart failure HF) and asymptomatic LVSD in adult lymphoma survivors (LSs) after autologous hematopoietic stem-cell transplantation (auto-HCT) and to identify risk factors for LVSD in this population. PATIENTS AND METHODS: All LSs treated with auto-HCT as adults in Norway from 1987 to 2008 were eligible for this national cross-sectional study. Asymptomatic LVSD was defined as left ventricular ejection fraction less than 50% by echocardiography, and HF was defined according to current recommendations. The results in LSs were compared with those found in an age- and sex-matched (1:1) control group. RESULTS: We examined 274 LSs (69% of all eligible survivors); 62% were men, the mean (± standard deviation) age was 56 ± 12 years, and mean follow-up time from lymphoma diagnosis was 13 ± 6 years. The mean cumulative doxorubicin dose was 316 ± 111 mg/m(2), and 35% of LSs had received additional radiation therapy involving the heart. We found LVSD in 15.7% of the LSs, of whom 5.1% were asymptomatic. HF patients were symptomatically mildly affected, with 8.8% of all LSs classified as New York Heart Association class II, whereas more severe HF was rare (1.8%). Compared with controls, LSs had a substantially increased LVSD risk (odds ratio, 6.6; 95% CI, 2.5 to 17.6; P < .001). A doxorubicin dose ≥ 300 mg/m(2) and cardiac radiation therapy dose greater than 30 Gy were independent risk factors for LVSD. CONCLUSION: LVSD was frequent and HF more prevalent than previously reported in LSs after auto-HCT. Our results may help to identify LSs at increased LVSD risk and can serve as a basis for targeted surveillance strategies.
Murbræch et al. (Tue,) conducted a cross-sectional in Lymphoma (n=274). Autologous hematopoietic stem-cell transplantation vs. Age- and sex-matched controls was evaluated on Left ventricular systolic dysfunction (LVSD) (OR 6.6, 95% CI 2.5-17.6, p=<0.001). Lymphoma survivors treated with autologous stem-cell transplantation had a significantly higher risk of left ventricular systolic dysfunction than matched controls (OR 6.6; 95% CI 2.5-17.6; P<0.001).