Abstract
We designed a prospective study to measure the left ventricular ejection fraction of 42 patients with non-Hodgkin lymphoma treated with Rituximab-based chemotherapy in a 1-h infusion. Our patients were not selected on the basis of their cardiac status. Cardiac history and other forms of co-morbidity were to be identified on entry. Before treatment, basal left ventricular ejection function (LVEF) was measured and every 6 months after treatment. Most patients were treated with CHOP-Rituximab combinations (79%). A drop in the post-treatment ejection fraction of over 10% from the pre-treatment base figure was found in 13 patients (31% of the total of the series, 39% of those receiving adriamycin-based chemotherapy). None of the patients without adriamycin had a decrease in LVEF. Three patients with drop >10% recovered normally, but when LVEF decreased by over 15%, which occurred in six patients (14.2%), none of them recovered normal level. Patients with normal systolic function had LVEF with a mean of 64.09 (+/-3.86) and patients with decreased systolic function had LVEF with a mean of 59.38 (+/-5.43). Though the data in this study suggest that rapid-infusion Rituximab does not cause relevant cardiac toxicity, there was a high percentage of reductions in LVEF of over 10%.
Publication types
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Research Support, Non-U.S. Gov't
MeSH terms
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Adult
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Aged
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Aged, 80 and over
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Antibodies, Monoclonal / administration & dosage
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Antibodies, Monoclonal / adverse effects
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Antibodies, Monoclonal / pharmacology*
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Antibodies, Monoclonal, Murine-Derived
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Antineoplastic Combined Chemotherapy Protocols / adverse effects
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Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
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Comorbidity
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Cyclophosphamide / administration & dosage
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Cyclophosphamide / adverse effects
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Cytokines / metabolism
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Doxorubicin / administration & dosage
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Doxorubicin / adverse effects
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Female
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Heart Diseases / epidemiology
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Humans
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Hyperlipidemias / epidemiology
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Hypertension / epidemiology
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Infusions, Intravenous / methods
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Lymphoma, B-Cell / drug therapy*
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Lymphoma, B-Cell / physiopathology
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Lymphoma, Large B-Cell, Diffuse / drug therapy
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Lymphoma, Large B-Cell, Diffuse / physiopathology
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Lymphoma, Non-Hodgkin / drug therapy
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Lymphoma, Non-Hodgkin / physiopathology
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Male
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Middle Aged
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Prednisone / administration & dosage
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Prednisone / adverse effects
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Prospective Studies
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Rituximab
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Smoking / epidemiology
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Stroke Volume / drug effects*
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Time Factors
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Ventricular Dysfunction, Left / chemically induced*
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Ventricular Dysfunction, Left / physiopathology
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Vincristine / administration & dosage
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Vincristine / adverse effects
Substances
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Antibodies, Monoclonal
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Antibodies, Monoclonal, Murine-Derived
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Cytokines
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Rituximab
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Vincristine
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Doxorubicin
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Cyclophosphamide
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Prednisone