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 Anticancer agents
Complications/Toxicities of treatment
Lymphomas
Surgical oncology
Therapy
Biological therapy
Radiation oncology
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.