What Is the Cardiac Impact of Chemotherapy and Subsequent Radiotherapy in Lymphoma Patients?(28 visite) Mercurio V, Cuomo A, Della Pepa R, Ciervo D, Cella L, Pirozzi F, Parrella P, Campi G, Franco R, Varricchi G, Abete P, Marone G, Petretta M, Bonaduce D, Pacelli R, Picardi M, Tocchetti CG
Antioxid Redox Signal (ISSN: 1523-0864linking, 1557-7716), 2019 Nov 20; 31
Tipo di articolo: News,
Impact factor: 7.581, Impact factor a 5 anni: 6.853
Url: Non disponibile.
Parole chiave: Adult Lymphoma
, Anthracycline Cardiotoxicity
, Cardiac Damage From Radiotherapy
, Oxidative Damage,
*** IBB - CNR *** Department of Translational Medical Sciences, Federico II University, Naples, Italy. Department of Medicine and Surgery, Federico II University, Naples, Italy. Institute of Biostructures and Bioimaging, National Research Council (CNR), Naples, Italy. Department of Advanced Biomedical Sciences, Federico II University, Naples, Italy. Interdepartmental Center for Clinical and Translational Research, Federico II University, Naples, Italy.
Anthracyclines are widely used in anticancer protocols, but can induce cardiotoxicity by mechanisms that mainly involve oxidative damage and mitochondrial dysfunction. Radiotherapy (RT) can also impair cardiac function by promoting myocardial fibrosis, microvascular damage, and decreased density of myocardial capillaries. Hence, we aim at investigating prospectively whether RT impacts heart function in lymphoma patients who had been already treated with anthracyclines. Twenty-nine consecutive patients with Hodgkin or non-Hodgkin lymphomas underwent echocardiography at baseline (before antineoplastic treatments), and then every 2 months, until 6 months after treatment completion. Echo evaluation included standard two-dimensional and speckle tracking. Twenty-two patients treated with anthracycline-based regimens were eligible. Out of the 22 patients, 8 received chemotherapy (CT) only (subgroup 1), while 14 underwent RT after CT [subgroup 2 (S2)]. At the end of CT, ejection fraction was significantly reduced in the whole population. At 6 months after completion of therapies, E/E' increased and global longitudinal strain was compromised in S2, suggesting additional damage induced by RT after CT. On the basis of the data from our small prospective study, we can hypothesize that in lymphoma patients, anthracyclines can worsen cardiac function, and RT may have an additional unfavorable myocardial impact.<br>