The effects of cardiovascular disease on the clinical outcome of elderly patients with diffuse large B-cell lymphoma

Huei Ting Tsai, Ruth M. Pfeiffer, Joan Warren, Wyndham Wilson, Ola Landgren

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

We identified 3910 elderly (>65 yrs) patients with diffuse large B-cell lymphoma (DLBCL) who received doxorubicin-based (+/-rituximab) therapy and 77 347 cancer-free controls, and assessed cardiovascular events and survival in relation to preexisting cardiovascular comorbidities. Compared to controls, patients with DLBCL had a 3.4-fold (95%CI 3.0-3.9) and 2.5-fold (95%CI 2.3-2.7) increased risk of congestive heart failure (CHF)/cardiomyopathy (CM) within 6 months and 3 years of diagnosis, respectively. Risk of acute myocardial infarction (AMI) was similarly increased. The risk of CHF/CM and AMI was significantly higher in those patients with DLBCL (vs. controls) who did not report preexisting cardiovascular disease, compared to those who had preexisting cardiovascular disease; this was due to dose reductions of doxorubicin among patients with preexisting cardiovascular disease. Rituximab improved survival in patients with stage III-IV (but not I-II) disease (p-interaction = 0.0003). Our novel findings emphasize the need to reduce cardiac toxicity of doxorubicin in elderly DLBCL patients.

Original languageEnglish (US)
Pages (from-to)682-687
Number of pages6
JournalLeukemia and Lymphoma
Volume56
Issue number3
DOIs
StatePublished - Mar 1 2015
Externally publishedYes

Keywords

  • Cardiovascular disease
  • doxorubicin
  • elderly cardiac failure
  • outcome
  • prognosis
  • rituximab
  • survival

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

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