Utility of Prechemotherapy Evaluation of Left Ventricular Function for Patients With Lymphoma

Steuter, John; Bociek, R. Gregory; Loberiza, Fausto R.; Mathers, Daniel; Armitage, Jamés O.; Vose, Julie M.; Bast, Martin; Saxena, S.N.; Porter, Thomas R.; Bierman, Philip J.

doi:10.1016/j.clml.2014.06.026

Cited by 10 publications

(12 citation statements)

References 25 publications

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“…We used these defined risk factors to develop a risk score (RS) which was then correlated with the obtained LVEF. Previous studies show the frequency of an abnormal LVEF ranged from 2.5% to 13.4%, while the percentage of patients in which chemotherapy plan changed was only 0%‐2.8% . In one of recent study by Truong et al, where 600 patients were studies, baseline LVEF assessment rarely changed the treatment plan in patients with no cardiac risk factors.…”

Section: Discussionmentioning

confidence: 97%

“…Previous studies show the frequency of an abnormal LVEF ranged from 2.5% to 13.4%, while the percentage of patients in which chemotherapy plan changed was only 0%-2.8%. 11,[33][34][35][36][37][38] The results of our study should be carefully interpreted, considering it being a single institute retrospective analysis. Given the low prevalence of baseline reduced LVEF and skew toward low-risk individuals with ≤2 risk factors (74% of study population), risk score derived from 26 clinical variables in an overfitted model could underestimate risk.…”

Section: Discussionmentioning

confidence: 98%

“…All these studies except the study done by Sabel et al included patients with known risk factors. Three trials were in breast cancer patients, 11,33,34 three were in non-Hodgkin's lymphoma and Hodgkin's lymphoma patients, 4,35,36 and two trials incorporated multiple tumor types. 37,38 The commonality of all these results lies in the consistent finding of very small if any benefit of LVEF assessments as a screening procedure.…”

Section: Discussionmentioning

confidence: 99%

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Utility of routine pretreatment evaluation of left ventricular ejection fraction in breast cancer patients receiving anthracyclines

et al. 2019

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Anthracycline‐based chemotherapy is widely used in the management of breast cancer. Despite the lack of clinical evidence, obtaining prechemotherapy left ventricular ejection fraction (LVEF) by echocardiogram or multigated acquisition scan is a widely adopted practice throughout the world. We present here the results of a retrospective analysis of breast cancer patients who had LVEF measurements in anticipation of an anthracycline chemotherapy to determine whether predefined cardiac risk factors predicted for poor cardiac function. Retrospective data were analyzed from 482 female breast cancer patients in whom LVEF was measured before starting anthracycline‐based chemotherapy. Baseline demographics and multiple risk factors associated with congestive heart failure were collected. Twenty‐six possible risk factors for CHF were defined, and the frequency of finding an abnormal LVEF as a function of total risk factors was assessed. Statistical tests include chi‐squared and logistic regression analysis. The median age of the study population was 52 years. The original chemotherapy plan was changed in 7 patients (1.45%) based on LVEF findings, all of which had asymptomatic LV dysfunction (LVEF ranging 40%‐50%). In 32 patients, despite normal LVEF results, anthracyclines were omitted secondary to prior cardiac issues. In 17 patients where LVEF was reported normal, anthracyclines were skipped based on patient's preference, tumor characteristics, or upstaging of the cancer based on imaging studies. No patient with ≤2 risk factors had an abnormal LVEF (N = 350). The probability of finding an abnormal LVEF in patients without any cardiac risk factors is extremely rare. Skipping baseline LVEF assessment may be an option in some patients with no cardiac risk factors undergoing anthracycline‐based chemotherapy.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Utility of routine pretreatment evaluation of left ventricular ejection fraction in breast cancer patients receiving anthracyclines

et al. 2019

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“…However, the utility of this approach has been debated due to a low prevalence of asymptomatic left ventricular systolic dysfunction, with this strategy missing most patients that will ultimately have cardiotoxicity (62). Serum biomarkers may be useful in predicting cardiotoxicity and the role of baseline assessment of serum biomarkers prior to cancer treatment in predicting cardiotoxicity is being evaluated (63).…”

Section: Preventionmentioning

confidence: 99%

Cardio-oncology in the older adult

Reddy

Shenoy

Blaes

2017

Journal of Geriatric Oncology

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Heart disease and cancer are the leading causes of death in older adults. Many first-line cancer treatments have the potential for cardiotoxicity. Age-related risk factors, pre-existing cardiac disease, and a high prevalence of comorbidities are reasons for increased cardiotoxicity in older adults. Concerns regarding cardiotoxicity may lead to frailty bias and undertreatment, resulting in suboptimal outcomes. There is an urgent need for geriatric-specific evidence and guidelines to help tailor care for this vulnerable group. A multi-disciplinary approach based on close collaboration between oncologists, cardiologists, and geriatricians, among other specialist clinicians is essential.

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“…Current diagnostic methods of myocardial damage used in clinic include electrocardiograph (ECG), Doppler echocardiography, brain natriuretic peptide, cardiac troponin-T, and creatine kinase-MB fraction levels. [ 6 , 7 ] Among these, ECG has the best cost performance and is most commonly used. For patients with acute or subacute myocardial damage which usually caused by edema of myocardial cells and myocardial cell vacuolar degeneration, the ECG manifested with nonspecific ST-T (ST segment-T wave) alternations, lowing and flatting of QRS wave (QRS complex), and prolongation of QT interval.…”

Section: Introductionmentioning

confidence: 99%

Changes in ischemia-modified albumin in myocardial toxicity induced by anthracycline and docetaxel chemotherapy

Xiao-dong¹,

Zhao²,

Hou³

et al. 2017

Medicine

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This study aims to evaluate differences in myocardial toxicity induced by different chemotherapy regimens. Patients were divided into 2 groups: epirubicin (EPI) combined with cyclophosphamide (EC) group and docetaxel combined with cyclophosphamide (TC) group. Changes in electrocardiograph (ECG) and ischemia-modified albumin (IMA) were determined pre- and 1, 3, and 6 courses of postchemotherapy. After the first course of chemotherapy, there was no significant difference in ECG and abnormal IMA incidence rates between the TC groups and EC groups (P > .05). After the third course and at the end of the sixth course, ECG and abnormal IMA incidence rates in the EC group were significantly higher than in the TC group (P < .05). Besides, IMA values significantly increased with the increase in chemotherapy courses in the EC group; and the value of the postsixth course was significantly higher than in the pre- and postfirst and -third courses of chemotherapy. IMA value in the postsixth course in the TC group was significantly higher than that in the pre- and postfirst and -third courses of chemotherapy. In addition, IMA values at the postfirst and -third courses of chemotherapy in the EC group were significantly higher than in the TC group. Both EC and TC chemotherapy regimens were harmful to the myocardium, and the incidence rate of myocardial damage increased with the increase of cumulative dose. Besides, the degree of myocardial damage in EC group was significantly higher than in the TC group.

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Utility of Prechemotherapy Evaluation of Left Ventricular Function for Patients With Lymphoma

Cited by 10 publications

References 25 publications

Utility of routine pretreatment evaluation of left ventricular ejection fraction in breast cancer patients receiving anthracyclines

Utility of routine pretreatment evaluation of left ventricular ejection fraction in breast cancer patients receiving anthracyclines

Cardio-oncology in the older adult

Changes in ischemia-modified albumin in myocardial toxicity induced by anthracycline and docetaxel chemotherapy

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