963P - Cardiotoxicity of high-dose chemotherapy with autologous hematopoietic stem cells transplantation in patients with malignant lymphomas. What is wor...

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Complications of Treatment
Lymphomas
Surgery and/or Radiotherapy of Cancer
Presenter Vladislav Sarzhevskiy
Citation Annals of Oncology (2014) 25 (suppl_4): iv327-iv339. 10.1093/annonc/mdu339
Authors V. Sarzhevskiy1, D. Kolesnikova2, V. Melnichenko1, M. Vakhromeeva1
  • 1Hematology, National Medical and Surgical Centre named after N.I. Pirogov, 105203 - Moscow/RU
  • 2Hematology, National Medical and Surgical Centre named after N.I. Pirogov, Moscow/RU

Abstract

Aim

High-dose chemotherapy (HDC) with autologous hematopoietic stem cells transplantation (auto-HSCT) is the standard of care for patients with relapsed malignant lymphomas. This method, however, has a number of toxic effects, including cardiotoxicity. As a conditioning regimen BEAM and CBV are used most frequently. These different regimens may have different cardiotoxicity profile.

Methods

The study included 80 patients (51 with Hodgkin's lymphoma, 29 with non-Hodgkin's lymphoma). 54 patients were conditioned with BEAM (carmustine, etoposide, cytarabine, and melphalan), 26 - with CBV (cyclophosphamide, carmustine, and etoposide). The groups were equal by age and sex. Examination of patients for evaluation of cardiotoxic effects of HDC and auto-HSCT was performed with echocardiography and measuring of levels of N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and troponin I.

Results

The median of left ventricular ejection fraction did not change significantly after HDC in both BEAM and CBV groups (61% and 62%, respectively) (P > 0.05). Median level of NT-proBNP in BEAM group before HDC was 100.5 pg/ml, in CBV group – 115.5 pg/ml (P > 0.05). After HDC median level of NT-proBNP increased to 154.7 pg/ml in BEAM group, and to 1051 pg/ml in CBV group (p <0.01). On D + 12 level estimated marker increased to 323.3 pg/ml in BEAM group, and decreased to 326.5 pg/ml in CBV group (P > 0.05). Increasing troponin level was observed in 14 of 54 patients (25.9%) in BEAM group and in 7 of 26 patients in CBV group (26.9%) (P > 0.05). No cases of myocardial infarction and other clinically significant cardiovascular abnormalities requiring cardiotropic therapy were observed.

Conclusions

The data obtained provide evidence of subclinical cardiotoxic effect of HDC and auto-HSCT in patients with malignant lymphomas. There is no difference of cardiotoxicity profile between BEAM and CBV.

Disclosure

All authors have declared no conflicts of interest.