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Abstract
Purpose: This study aims to evaluate the role of high-sensitivity troponin T (hsTnT) as a complementary tool for determining cardiotoxicity in non-Hodgkin lymphoma (NHL) patients receiving cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) regimen chemotherapy. Methods: We included 35 patients diagnosed with NHL who received CHOP chemotherapy. Left ventricular ejection fraction (LVEF) and hsTnT were measured at two time points: before the first cycle (pre-test) and after the fourth cycle (post-test). The LVEF and hsTnT were analysed using IBM SPSS version 24 through the paired-sample T-test, Wilcoxon signed-rank test, Pearson’s correlation and Spearman’s correlation. Results: There was a significant difference in both LVEF and hsTnT between pre-chemotherapy and post-4th chemotherapy cycles (P = 0.001). However, more contrast difference from the baseline value of hsTnT compared to LVEF could be observed. LVEF did not detect any deterioration in myocardial function. However, 10 out of 35 subjects exhibit hsTnT higher than the 99th percentile of the population (>14 pg/ml), suggesting that myocardial injury (MI) could be detected. There was no correlation between LVEF and hsTnT (P > 0.05). Conclusion: HsTnT, together with LVEF, could complement each other and offer better coverage for detecting cardiotoxicity during the administration of CHOP in NHL patients. An insignificant correlation between hsTnT and LVEF showed that cardiotoxicity existed in a broad spectrum including cellular damage and functional impairment, as hsTnT represents cellular damage, and LVEF reflects heart functional capacity.
Highlights
Non-Hodgkin lymphoma (NHL) accounts for 90% of lymphoma cases around the world, and 509.590 new cases of NHL were recorded all over the world in 2018.1 In the clinical setting, NHL presents with a wide range of clinical manifestations that makes treating NHL a challenge among clinicians.2 1|PageChemotherapy is the treatment of choice for NHL.[3]
This study aims to evaluate the role of high-sensitivity troponin T as a complementary tool for determining cardiotoxicity in non-Hodgkin lymphoma (NHL) patients
Left ventricular ejection fraction (LVEF) and high-sensitivity troponin T (hsTnT) were measured at two time points: before the first cycle and after the fourth cycle
Summary
Non-Hodgkin lymphoma (NHL) accounts for 90% of lymphoma cases around the world, and 509.590 new cases of NHL were recorded all over the world in 2018.1 In the clinical setting, NHL presents with a wide range of clinical manifestations that makes treating NHL a challenge among clinicians.2 1|Page. Chemotherapy is the treatment of choice for NHL.[3] The CHOP (cyclophosphamide, doxorubicin, vincristine and prednisone) regimen as combined chemotherapy is the first-line regimen for the treatment of NHL, even though its use is limited due to doxorubicin cardiotoxicity.[4,5,6] Heart Failure (HF) as manifestation of chemotherapy-associated cardiotoxicity increases mortality and morbidity of patients receiving anthracycline, even after the end of chemotherapy.[7,8] Left ventricular ejection fraction (LVEF) measurement by echocardiography is a primary cardiotoxicity monitoring modality. A decrease in LVEF reflects the deterioration of heart contractility as a manifestation of doxorubicin cardiotoxicity.[8] regardless of echocardiography benefits, the t heart condition that is represented in LVEF is limited to cardiac functional spectrum. Damage at the cellular level might have occurred
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