Clinical Study On The Cardiotoxicity Of Anthracyclines In Chemotherapy Of Non-Hodgkin Lymphoma

Purpose:To analyze the clinical features of cardiotoxicity and the correlation factors of cardiotoxicity induced after treatment with anthracyclines for non-Hodgkin's lymphoma.Methods:The clinical features of 94 patients with non-Hodgkin's lymphoma were retrospectively analyzed.The clinical symptoms and objective examination indicators,such as the electrocardiogram,myocardial enzymes,cardiac troponin T, and cardiac ultrasound results of the patients before and after chemotherapy were compared.The correlation between the happening of cardiotoxicity and the factors of accumulated dose,the patient's age,sex,past history of cardiovascular,lymphoma type and stage,the existence of chromosomal abnormalities,the degree of anemia, hepatic and renal function,LDH,the use of EPO and the protective treatment of cardiac etc.were studied.The correlation risk factors of cardiotoxicity induced after treatment with anthracyclines for non-Hodgkin's lymphoma were analyzed by the regression analysis.Results:Of all the 94 patients,the incidence rate of cardiotoxicity was 20.2%, 16.0%was acute or subacute cardiotoxicity,4.2%was chronic cardiotoxicity.The median accumulated anthracycline dose were 142.9 mg/m~2,the median courses of treatment were six,the median time were 34 weeks when they developed cardiotoxicity.The difference between cardiotoxicity induced by accumulated anthracycline dose was significant(P=0.001),and there was a positive correlation(r =0.443,P=0.000)between them.There was a positive correlation between cardiotoxicity and the patients' age.The incidence of cardiotoxicity was higher in the over 55-year-old age group.There was a correlation between cardiotoxicity and sex. The risk of cardiotoxicity of female patients below 55-year-old age group was higher. There was no correlation between cardiotoxicity and the history of angiocardiopathy, the type and staging of lymphoma,the chromosomal abnormality,the degree of anemia,tumor load and whether giving protective treatment to the heart,etc.Conclusion:There was a correlation between cardiotoxicity and accumulated anthracycline dose,the patients' age and sex.The cumulative dose of anthracyclines was the independent risk factor for inducing heart injuries.Accumulated anthracycline dose should be strictly restricted during the course of the treatment. Elder and female patients should be paid more attention,and the protective treatment of cardiac should be used.