Abstract

Among the types of blood cancers, non-Hodgkin lymphoma is the most common. The usual treatments for this type of cancer can cause heart failure. A descriptive observational study was conducted that included 16 non-Hodgkin lymphoma survivors and 16 healthy controls matched by age and sex. Vagal tone was evaluated in the short term with a three-channel Holter device, and the time and frequency domains were analyzed following a previously accepted methodology to evaluate cardiac autonomic balance. The results of the analysis revealed that the standard deviation of the NN interval (F = 6.25, p = 0.021) and the square root of the mean of the sum of the differences between NN intervals (F = 9.74, p = 0.004) were significantly higher in healthy subjects than in lymphoma survivors. In the heart rate variability (HRV) index, there were no significant differences between the groups (F = 0.03, p = 0.85), nor in the parameters of the frequency domains LF (F = 1.94, p = 0.17), HF (F = 0.35, p = 0.55), and the ratio LF/HF (F = 3.07, p = 0.09). HRV values were lower in non-Hodgkin lymphoma survivors in the first year after treatment, resulting in autonomic imbalance compared to healthy paired subjects.

Highlights

  • According to the World Health Organization, cancer is the leading cause of death worldwide and there are around 18.1 million new cases every year, expected to increase to 24 million cases by 2035 [1,2]

  • Inclusion criteria were a primary diagnosis of non-Hodgkin lymphoma cancer (Grades I-IIIa), age between 18 and 65 years, and the primary part of cancer treatment having been completed 6 months to 1 year earlier

  • The main finding in this study was the presence of autonomic imbalance in nonHodgkin lymphoma survivors during their first year after completing treatment compared to healthy paired subjects, evidenced by the lower values of time domain measures in heart rate variability (SDNN and RMSSD)

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Summary

Introduction

According to the World Health Organization, cancer is the leading cause of death worldwide and there are around 18.1 million new cases every year, expected to increase to 24 million cases by 2035 [1,2]. Within the World Health Organization’s global hematic cancers, non-Hodgkin lymphoma had 509,590 (2.8%) new cases worldwide in 2018 in both genders. It ranks eleventh in new cases for 2018 [1]. In terms of mortality rate, non-Hodgkin lymphoma cancer caused 248,724 deaths in 2018 in both genders worldwide. In Spain, in 2020, non-Hodgkin lymphoma was one of the most diagnosed blood cancers (9188), being in the top 10 positions [2]. Worldwide, it is the most frequent, accounting for 3.0% with a mortality rate of 2.6% [3]. Mortality from this tumor type has decreased since the late 1990s at a rate of 3% annually, reflecting a clear improvement in the effectiveness of treatments [2]

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