1. Non-pegylated liposomal doxorubicin in lymphoma: patterns of toxicity and outcome in a large observational trial.
- Author
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Wasle I, Gamerith G, Kocher F, Mondello P, Jaeger T, Walder A, Auberger J, Melchardt T, Linkesch W, Fiegl M, and Mian M
- Subjects
- Adult, Aged, Aged, 80 and over, Doxorubicin therapeutic use, Female, Humans, Male, Middle Aged, Polyethylene Glycols therapeutic use, Retrospective Studies, Treatment Outcome, Antibiotics, Antineoplastic therapeutic use, Doxorubicin analogs & derivatives, Drug-Related Side Effects and Adverse Reactions epidemiology, Lymphoma drug therapy, Lymphoma epidemiology
- Abstract
The anthracycline doxorubicin plays a major role in the treatment of lymphoproliferative disorders. However, its use is often limited due to cardiac toxicity, which seems to be much less in the liposomal non-pegylated formulation (Myocet®). The aim of this study was the evaluation of efficacy and toxicity of Myocet®-containing treatment regimens, with a focus on cardiotoxicity during treatment in lymphoma patients. A total of 326 consecutive patients, treated between March 2008 and December 2013 in 11 Austrian and 1 Italian cancer centers, were retrospectively assessed. Patients' baseline and treatment-related parameters were obtained by reviewing hospital records. Median age was 74 years (range 26-93). The most common histology was DLBCL (60 %), followed by FL (13 %) and MCL (8 %). At least one cardiovascular comorbidity was present in 72 % of patients. Most common grade 3/4 toxicities were hematologic, namely, leukopenia, neutropenia, thrombocytopenia, and febrile neutropenia in 44, 40, 17, and 16 %. Overall, 43 patients suffered a cardiac event (any grade) with most patients developing congestive heart failure. Parameters significantly associated with severe cardiac events (grades 3-5) were the presence of cardiovascular comorbidities, chronic obstructive pulmonary disease, and elevated baseline NT-proBNP. Treatment response after first line Myocet®-containing therapy was ≥58 % among all entities (range 58-86 %) and therefore comparable to those of conventional therapeutic regimens. Herein, we provide a detailed toxicity profile of Myocet®-containing chemotherapy regimens. Despite the high rate of patients with preexisting comorbidities, the number of adverse events was encouraging. However, these results need to be confirmed in a prospective randomized trial.
- Published
- 2015
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