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URL http://www.rockymountainbmt.com/news/Natriuretic-peptides-reflect-the-transient-cardiac-effect-following-high-dose-cyclophosphamide-in-patients-with-non-Hodgkins-lymphoma-5068.html

Natriuretic peptides reflect the transient cardiac effect following high-dose cyclophosphamide in patients with non-Hodgkin's lymphoma

10-04-2006

According to recently published research from Finland, "Limited data are available on the cardiac effects of high-dose cyclophosphamide (CY) in patients with non-Hodgkin's lymphoma (NHL). We prospectively assessed the cardiac effects of high-dose CY in 30 adult NHL patients receiving CY 6 g/m2 as part of BEAC high-dose therapy (HDT).

"Radionuclide ventriculography (RVG) and plasma natriuretic peptide (NT-proANP, NT-proBNP) measurements were performed simultaneously prior to BEAC at baseline (d-7), 12 days (d+12) and 3 months (m+3) after stem cell infusion (D0). In addition to these time points, natriuretic peptides were measured 2 days before (d-2) and 1 week (d+7) after stem cell infusion."

"Left ventricular ejection fraction (LVEF) decreased from d-7 (53%+/-2%) to d+12 (49%+/-2%, p=0.009). However," T. Kuittinen and colleagues at Kuopio University wrote, "no significant change in cardiac diastolic function was observed. The LVEF returned towards baseline by m+3."

"Plasma NT-proANP and NT-proBNP increased significantly from baseline (445+/-65 pmol/L and 129+/-33 pmol/L) to d-2 (1127+/-142 pmol/L, p<0.001 and 624+/-148 pmol/L, p<0.001, respectively).

"Thereafter," continued scientists, "they started to decrease, but on d+7 NT-proANP (404+/-157 pmol/L, p=0.048) and NT-proBNP (648+/-125 pmol/L, p=0.015) were still significantly higher than at baseline. On d+12 and m+3 they no longer differed from baseline."

Kuittinen concluded, "Our findings suggest that high-dose CY results in acute, subclinical systolic dysfunction in NHL patients previously treated with anthracyclines.

"Natriuretic peptides seem to be more sensitive than LVEF to reflect this transient cardiac effect. Serial measurements of natriuretic peptides might be a useful tool to assess cardiac effects of high-dose CY."

Kuittinen and colleagues published their study in European Journal of Haematology (Cardiac effects within 3 months of BEAC high-dose therapy in non-Hodgkin's lymphoma patients undergoing autologous stem cell transplantation. Eur J Haematol, 2006;77(2):120-127).

For additional information, contact T. Kuittinen, Kuopio University, Dept. of Medical, POB 1777, SF-70210 Kuopio, Finland.

This article was prepared by Clinical Oncology Week editors from staff and other reports. Copyright 2006, Clinical Oncology Week via NewsRx.com.