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Annals of Hematology

, Volume 94, Issue 4, pp 593–601 | Cite as

Non-pegylated liposomal doxorubicin in lymphoma: patterns of toxicity and outcome in a large observational trial

  • Ines Wasle
  • Gabriele Gamerith
  • Florian Kocher
  • Patrizia Mondello
  • Thomas Jaeger
  • Alois Walder
  • Jutta Auberger
  • Thomas Melchardt
  • Werner Linkesch
  • Michael Fiegl
  • Michael MianEmail author
Original Article

Abstract

The anthracycline doxorubicin plays a major role in the treatment of lymphoproliferative disorders. However, its use is often limited due to cardiac toxicity, which seems to be much less in the liposomal non-pegylated formulation (Myocet®). The aim of this study was the evaluation of efficacy and toxicity of Myocet®-containing treatment regimens, with a focus on cardiotoxicity during treatment in lymphoma patients. A total of 326 consecutive patients, treated between March 2008 and December 2013 in 11 Austrian and 1 Italian cancer centers, were retrospectively assessed. Patients’ baseline and treatment-related parameters were obtained by reviewing hospital records. Median age was 74 years (range 26–93). The most common histology was DLBCL (60 %), followed by FL (13 %) and MCL (8 %). At least one cardiovascular comorbidity was present in 72 % of patients. Most common grade 3/4 toxicities were hematologic, namely, leukopenia, neutropenia, thrombocytopenia, and febrile neutropenia in 44, 40, 17, and 16 %. Overall, 43 patients suffered a cardiac event (any grade) with most patients developing congestive heart failure. Parameters significantly associated with severe cardiac events (grades 3–5) were the presence of cardiovascular comorbidities, chronic obstructive pulmonary disease, and elevated baseline NT-proBNP. Treatment response after first line Myocet®-containing therapy was ≥58 % among all entities (range 58–86 %) and therefore comparable to those of conventional therapeutic regimens. Herein, we provide a detailed toxicity profile of Myocet®-containing chemotherapy regimens. Despite the high rate of patients with preexisting comorbidities, the number of adverse events was encouraging. However, these results need to be confirmed in a prospective randomized trial.

Keywords

Anthracycline Cardiac toxicity Lymphoma Myocet R-CHOP 

Notes

Acknowledgments

The authors thank Stephan Gritsch (Innsbruck), August Zabernigg (Kufstein), Reinhard Stauder (Innsbruck), Wolfgang Willenbacher (Innsbruck), Michael Steurer (Innsbruck), Günther Gastl (Innsbruck), Günther Zangerl (Zams), Michael Schnallinger (St. Johann) and Stephan Schreieck (Reutte), for providing patient data and advice.

Conflict of interest

This study was supported by the “Verein für Tumorforschung.” Ines Wasle, PhD student, received an unrestricted research grant by the Austrian Ratiopharm Arzneimittel Vertriebs-GmbH. Michael Fiegl received honoraria for lectures (Roche, TEVA). Michael Fiegl and Michael Mian are consultants of TEVA.

Supplementary material

277_2014_2250_MOESM1_ESM.docx (33 kb)
Supplementary Table 1 (DOCX 33 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Ines Wasle
    • 1
    • 3
  • Gabriele Gamerith
    • 1
  • Florian Kocher
    • 1
    • 8
  • Patrizia Mondello
    • 2
  • Thomas Jaeger
    • 3
  • Alois Walder
    • 4
  • Jutta Auberger
    • 5
  • Thomas Melchardt
    • 5
  • Werner Linkesch
    • 6
  • Michael Fiegl
    • 1
  • Michael Mian
    • 1
    • 7
    Email author
  1. 1.Department of Internal Medicine V (Haematology and Oncology)Medical University of InnsbruckInnsbruckAustria
  2. 2.Department of Medical OncologyUniversity of MessinaMessinaItaly
  3. 3.Department Internal Medicine E/OncologyLandeskrankenhaus RankweilRankweilAustria
  4. 4.Department Internal MedicineBezirkskrankenhaus LienzLienzAustria
  5. 5.3rd Medical DepartmentParacelsus Medical University SalzburgSalzburgAustria
  6. 6.Department of Internal Medicine, Division of HaematologyMedical University of GrazGrazAustria
  7. 7.Department of Hematology and CBMTHospital of BolzanoBolzanoItaly
  8. 8.Tyrolean Cancer Research InstituteInnsbruckAustria

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