Cardiovascular diseases after high-dose chemotherapy and autologous stem cell transplant for lymphoma: A Danish population-based study
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Cardiovascular diseases after high-dose chemotherapy and autologous stem cell transplant for lymphoma : A Danish population-based study. / Baech, Joachim; Husby, Simon; Trab, Trine; Kragholm, Kristian; Brown, Peter; Gørløv, Jette S.; Jørgensen, Judit M.; Gudbrandsdottir, Sif; Severinsen, Marianne Tang; Grønbæk, Kirsten; Larsen, Thomas Stauffer; Wästerlid, Tove; Eloranta, Sandra; Smeland, Knut B.; Jakobsen, Lasse Hjort; El-Galaly, Tarec C.
In: British Journal of Haematology, Vol. 204, No. 3, 2024, p. 967-975.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Cardiovascular diseases after high-dose chemotherapy and autologous stem cell transplant for lymphoma
T2 - A Danish population-based study
AU - Baech, Joachim
AU - Husby, Simon
AU - Trab, Trine
AU - Kragholm, Kristian
AU - Brown, Peter
AU - Gørløv, Jette S.
AU - Jørgensen, Judit M.
AU - Gudbrandsdottir, Sif
AU - Severinsen, Marianne Tang
AU - Grønbæk, Kirsten
AU - Larsen, Thomas Stauffer
AU - Wästerlid, Tove
AU - Eloranta, Sandra
AU - Smeland, Knut B.
AU - Jakobsen, Lasse Hjort
AU - El-Galaly, Tarec C.
N1 - Publisher Copyright: © 2023 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.
PY - 2024
Y1 - 2024
N2 - Cardiovascular diseases, especially congestive heart failure (CHF), are known complications of anthracyclines, but the risk for patients undergoing high-dose chemotherapy and autologous stem cell transplant (HDT-ASCT) is not well established. With T-cell therapies emerging as alternatives, studies of long-term complications after HDT-ASCT are warranted. Danish patients treated with HDT-ASCT for aggressive lymphoma between 2001 and 2017 were matched 1:5 on sex, birth year and Charlson comorbidity score to the general population. Events were captured using nationwide registers. A total of 787 patients treated with HDT-ASCT were identified. Median follow-up was 7.6 years. The risk of CHF was significantly increased in the HDT-ASCT population compared to matched comparators with an adjusted hazard ratio (HR) of 5.5 (3.8–8.1). The 10-year cumulative incidence of CHF was 8.0% versus 2.0% (p < 0.001). Male sex, ≥2 lines of therapy, hypertension and cumulative anthracycline dose (≥300 mg/m2) were risk factors for CHF. In a separate cohort of 4089 lymphoma patients, HDT-ASCT was also significantly associated with increased risk of CHF (adjusted HR of 2.6 [1.8–3.8]) when analysed as a time-dependent exposure. HDT-ASCT also increased the risk of other cardiac diseases. These findings are applicable for the benefit/risk assessment of HDT-ASCT versus novel therapies.
AB - Cardiovascular diseases, especially congestive heart failure (CHF), are known complications of anthracyclines, but the risk for patients undergoing high-dose chemotherapy and autologous stem cell transplant (HDT-ASCT) is not well established. With T-cell therapies emerging as alternatives, studies of long-term complications after HDT-ASCT are warranted. Danish patients treated with HDT-ASCT for aggressive lymphoma between 2001 and 2017 were matched 1:5 on sex, birth year and Charlson comorbidity score to the general population. Events were captured using nationwide registers. A total of 787 patients treated with HDT-ASCT were identified. Median follow-up was 7.6 years. The risk of CHF was significantly increased in the HDT-ASCT population compared to matched comparators with an adjusted hazard ratio (HR) of 5.5 (3.8–8.1). The 10-year cumulative incidence of CHF was 8.0% versus 2.0% (p < 0.001). Male sex, ≥2 lines of therapy, hypertension and cumulative anthracycline dose (≥300 mg/m2) were risk factors for CHF. In a separate cohort of 4089 lymphoma patients, HDT-ASCT was also significantly associated with increased risk of CHF (adjusted HR of 2.6 [1.8–3.8]) when analysed as a time-dependent exposure. HDT-ASCT also increased the risk of other cardiac diseases. These findings are applicable for the benefit/risk assessment of HDT-ASCT versus novel therapies.
KW - cardiology
KW - cytotoxicity
KW - epidemiology
KW - high-dose therapy
KW - lymphoma
U2 - 10.1111/bjh.19272
DO - 10.1111/bjh.19272
M3 - Journal article
C2 - 38155503
AN - SCOPUS:85180847960
VL - 204
SP - 967
EP - 975
JO - British Journal of Haematology
JF - British Journal of Haematology
SN - 0007-1048
IS - 3
ER -
ID: 382555482