An Assessment of Race as a Risk Factor for Doxorubicin-Related Cardiotoxicity in Diffuse Large B-Cell Lymphoma |
| |
| Affiliation: | 1. Weill Cornell Medicine, New York, NY;2. Department of Population Health Sciences, Weill Cornell Medicine, New York, NY;3. Department of Medicine, Division of Hematology and Oncology, Weill Cornell Medicine, New York, NY;1. Service of Hematology, Transfusion and Cell Therapy and Laboratory of Medical Investigation in Pathogenesis and Directed Therapy in Onco-Immuno-Hematology (LIM-31) HCFMUSP, University of Sao Paulo Medical School, Sao Paulo, Brazil;2. Laboratorio de Genética Hematológica, Instituto de Medicina Experimental (IMEX-CONICET)/Academia Nacional de Medicina;3. On behalf of the Grupo de Estudio de SMD, Sociedad Argentina de Hematología, Buenos Aires, Argentina;4. Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Brazil;5. Hematology Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina;6. Hematology Department, Hospital Italiano de La Plata, Buenos Aires, Argentina;7. Federal University of Ceara, Departament of Internal Medicine, Ceara, Brazil;8. Hematology Department, Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, Brazil;9. Laboratory of Pathology of the Heart Institute (InCor), Hospital das Clinicas (HC-FMUSP), University of Sao Paulo, Sao Paulo, Brazil;10. The Fleury Group, Sao Paulo/SP, Brazil;11. Department of Imaging, Hematology and Oncology, University of Sao Paulo at Ribeirao Preto Medical School, Ribeirao Preto, Sao Paulo, Brazil;12. Genetics Laboratory, Hospital Israelita Albert Einstein, Sao Paulo, Brazil;1. Memorial Sloan Kettering Cancer Center;2. Weill Cornell Medicine;3. New York Presbyterian Hospital;1. Ankara University, Faculty of Medicine, Department of Hematology, Ankara, Turkey;2. Ankara University, Faculty of Medicine, Department of Sports Medicine, Ankara, Turkey;3. Ankara University, Faculty of Medicine, Department of Internal Medicine, Ankara, Turkey;1. Institute for Clinical Research & Health Policy Studies, Tufts Medical Center, Boston, MA;2. Division of Hematology/Oncology, Tufts Medical Center, Boston, MA;3. Department of Medicine and Pediatrics, Tufts University School of Medicine, Boston, MA |
| |
| Abstract: | ![]()
BackgroundDoxorubicin carries a risk of congestive heart failure (CHF). Black race has been suggested as a risk factor for doxorubicin-related cardiotoxicity, but data are limited. We assessed whether HF occurs at higher rates in Black patients compared to White patients who receive doxorubicin for DLBCL, and evaluated race as an independent risk factor for the development of HF after adjusting for known risk factors.Patients and MethodsWe used SEER-Medicare to identify patients 66 years and older with DLBCL. We excluded patients with CHF documented prior to diagnosis with DLBCL. We assessed for hypertension, type 2 diabetes, coronary artery disease, and arrhythmias prior to diagnosis with DLBCL. The primary outcome was documented CHF at any point following DLBCL diagnosis. Secondary outcomes included CHF in the first year following diagnosis and death. We performed analyses additionally stratified by cumulative dose of doxorubicin.ResultsOur study population consisted of 8,604 patients (White 96.8%, Black 3.2%). In both Kaplan-Meier and competing risk analyses, we observed no significant difference in the incidence of CHF between Black and White patients, both before and after adjusting for covariates. Finally, we observed no significant differences in the incidence of CHF by race after stratification by cumulative doxorubicin dose.ConclusionsCHF is common following doxorubicin chemotherapy for DLBCL in older patients. No association was observed between Black race and the onset of heart failure in this setting. Rigorous screening for known clinical risk factors is likely more relevant than race in treatment selection and optimization. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
