Cardiovascular diseases after high-dose chemotherapy and autologous stem cell transplant for lymphoma: A Danish population-based study

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  • Joachim Baech
  • Simon Husby
  • Trab, Trine
  • Kristian Kragholm
  • Brown, Peter de Nully
  • Jette S. Gørløv
  • Judit M. Jørgensen
  • Sif Gudbrandsdottir
  • Marianne Tang Severinsen
  • Grønbæk, Kirsten
  • Thomas Stauffer Larsen
  • Tove Wästerlid
  • Sandra Eloranta
  • Knut B. Smeland
  • Lasse Hjort Jakobsen
  • Tarec C. El-Galaly

Cardiovascular diseases, especially congestive heart failure (CHF), are known complications of anthracyclines, but the risk for patients undergoing high-dose chemotherapy and autologous stem cell transplant (HDT-ASCT) is not well established. With T-cell therapies emerging as alternatives, studies of long-term complications after HDT-ASCT are warranted. Danish patients treated with HDT-ASCT for aggressive lymphoma between 2001 and 2017 were matched 1:5 on sex, birth year and Charlson comorbidity score to the general population. Events were captured using nationwide registers. A total of 787 patients treated with HDT-ASCT were identified. Median follow-up was 7.6 years. The risk of CHF was significantly increased in the HDT-ASCT population compared to matched comparators with an adjusted hazard ratio (HR) of 5.5 (3.8–8.1). The 10-year cumulative incidence of CHF was 8.0% versus 2.0% (p < 0.001). Male sex, ≥2 lines of therapy, hypertension and cumulative anthracycline dose (≥300 mg/m2) were risk factors for CHF. In a separate cohort of 4089 lymphoma patients, HDT-ASCT was also significantly associated with increased risk of CHF (adjusted HR of 2.6 [1.8–3.8]) when analysed as a time-dependent exposure. HDT-ASCT also increased the risk of other cardiac diseases. These findings are applicable for the benefit/risk assessment of HDT-ASCT versus novel therapies.

TidsskriftBritish Journal of Haematology
Udgave nummer3
Sider (fra-til)967-975
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
Research supported by Rigshospitalet Research Fund, the Danish Cancer Society (grant numbers: R274‐A17146 and R306‐A18107) and the Nordic Cancer Union (grant number: R278‐A15872).

Publisher Copyright:
© 2023 The Authors. British Journal of Haematology published by British Society for Haematology and John Wiley & Sons Ltd.

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