Markers Determining the Risk of Cardiovascular Toxicity Against the Background of Antitumor Immunochemotherapy

Introduction. Malignant neoplasms occupy a leading place among the causes of death in the population. Despite the fact that antitumor treatment can significantly prolong the life of cancer patients, it continues to have a toxic effect on organs and systems. Patients with non-Hodgkin’s lymphoma of the indolent type receiving anthracycline-containing therapy regimens, which are the leading treatment regimens due to their availability from the pharmacological and financial side in the Russian Federation, are no exception. The purpose of the study. To identify clinical, laboratory and instrumental indicators, assessed after 3 months of treatment, determining the risk of developing cardiovascular toxicity against the background of 6-month antitumor immunochemotherapy according to the R-CHOP scheme in patients with indolent type of non-Hodgkin’s lymphomas. Materials and methods. An observational case-control study was conducted on the bases of medical institutions in Samara for patients diagnosed with B-cell follicular lymphoma, who were shown to undergo 6 courses of immunochemotherapy in the R-CHOP mode. The patients were divided into two groups: the main group n=21 (16 (76.2 %) men, average age 55.2(9.8) years) with verified cardiovascular toxicity and the control group n=51 (21 (41.2 %) men, average age 53.7(13.6) years) without her. During treatment, the targets were evaluated in two stages: at the start and after three courses of therapy. Results. At the start of the study, patients with verified cardiovascular toxicity had higher values of BMI, CDR, CDR, CDR, volume of the left and right atria, and distal diameter of the excretory tract compared with the control group (p < 0.05). Also, in patients with cardiovascular toxicity, the QTc significantly prolonged during treatment from 360 (245.0; 411.0) to 412 (279.0; 450.0) msec., p=0.032; the concentration of NTproBNP increased from 77 (67.0; 109.0) to 110 (75.0; 222.0) mg/ml, p=0.032; and the value of GLS LV decreased from -21.1 (19.7; 22.4) to -17.7 (15.1; 21.0)%, p=0.004. Conclusion. The expansion of diagnostic protocols within the framework of cardiovascular toxicity among patients with B-cell follicular lymphoma allows timely optimization of management tactics for patients with oncohematological profile.

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