Contributions
Abstract: PB2517
Type: Publication Only
Background
An increased incidence of atherosclerosis has been noted in cancer survivors. In past, there only were a few reports on the relation between atherosclerosis and chemotherapy. As a mechanism for the progression of atherosclerosis with chemotherapy, the reduction of nitric oxide from endothelial cells has been reported apart from complications of metabolic diseases. We have also reported a case who was 68-year-old female with follicular lymphoma, clinical stage IVA showing the plaque formation of carotid artery and the elevation of cardio-ankle vascular index (CAVI) after the eight courses of R-CHOP therapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) without complication of diabetes mellitus and hyperlipidemia.
Aims
So, herein we evaluate the risk for the development of atherosclerosis with chemotherapy using an arterial stiffness parameter, the CAVI, the findings of carotid artery ultrasonography and the value of von Willebrand factor (vWF) as an endothelial damage in the patients with malignant lymphoma who were treated with R-CHOP therapy.
Methods
We enrolled eight patients who were diagnosed B-cell malignant lymphoma and finished with treating with R-CHOP therapy from December of 2016 to August of 2017. We evaluated the atherosclerosis with CAVI index, carotid artery ultrasonography and the value of vWF during each consecutive chemotherapy. The Ethics Committee in Toho University approved this study, and we obtained informed consent.
Results
Seven men and one woman were registered (the median age, 72.5 years old). Every eight patients achieved complete remission after chemotherapy. Two patients were treated with 6th course, one patient with 7th course and the other patients were with 8th course of R-CHOP therapy. Two patients had not evaluated the vWF after final therapy, and we missed to check the value of vWF in some patients during the treatment, so evaluable number of patients were shown as in Figure. Almost all patients showed elevation of the vWF with the progression of treatment. The value of vWF of pretreatment (132.5 ± 44.4) elevated significantly (p = 0.0227) to 186 ± 44.5 at just before second treatment. Comparing the value of vWF of pretreatment and another point, vWF elevated significantly as follows (just before 4th treatment;184.5 ± 40.8, p=0.0117, just before 6th treatment;189.5 ± 31.5, p=0.0117). After the treatment, the value decreased in all the patients, however there was not significant difference (p=0.0796). Six patients out of eight patients showed the progression of atherosclerosis, new plaque formation or progression of intima-media thickness by carotid artery ultrasonography. In evaluation of CAVI index, some patients showed the elevation of index with the progression of treatment. However, there was not significant elevation at all during the treatment.
Conclusion
We reported that malignant lymphoma patients showed the significant elevation of vWF during the R-CHOP therapy. We speculate that this therapy may be the risk of progression of atherosclerosis via vascular endothelial damage. Further study will be required to clarify the relationship between chemotherapy and arteriosclerosis.
Session topic: 35. Thrombosis and vascular biology & translational Research
Keyword(s): Atherosclerosis, Malignant lymphoma, Rituximab
Abstract: PB2517
Type: Publication Only
Background
An increased incidence of atherosclerosis has been noted in cancer survivors. In past, there only were a few reports on the relation between atherosclerosis and chemotherapy. As a mechanism for the progression of atherosclerosis with chemotherapy, the reduction of nitric oxide from endothelial cells has been reported apart from complications of metabolic diseases. We have also reported a case who was 68-year-old female with follicular lymphoma, clinical stage IVA showing the plaque formation of carotid artery and the elevation of cardio-ankle vascular index (CAVI) after the eight courses of R-CHOP therapy (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) without complication of diabetes mellitus and hyperlipidemia.
Aims
So, herein we evaluate the risk for the development of atherosclerosis with chemotherapy using an arterial stiffness parameter, the CAVI, the findings of carotid artery ultrasonography and the value of von Willebrand factor (vWF) as an endothelial damage in the patients with malignant lymphoma who were treated with R-CHOP therapy.
Methods
We enrolled eight patients who were diagnosed B-cell malignant lymphoma and finished with treating with R-CHOP therapy from December of 2016 to August of 2017. We evaluated the atherosclerosis with CAVI index, carotid artery ultrasonography and the value of vWF during each consecutive chemotherapy. The Ethics Committee in Toho University approved this study, and we obtained informed consent.
Results
Seven men and one woman were registered (the median age, 72.5 years old). Every eight patients achieved complete remission after chemotherapy. Two patients were treated with 6th course, one patient with 7th course and the other patients were with 8th course of R-CHOP therapy. Two patients had not evaluated the vWF after final therapy, and we missed to check the value of vWF in some patients during the treatment, so evaluable number of patients were shown as in Figure. Almost all patients showed elevation of the vWF with the progression of treatment. The value of vWF of pretreatment (132.5 ± 44.4) elevated significantly (p = 0.0227) to 186 ± 44.5 at just before second treatment. Comparing the value of vWF of pretreatment and another point, vWF elevated significantly as follows (just before 4th treatment;184.5 ± 40.8, p=0.0117, just before 6th treatment;189.5 ± 31.5, p=0.0117). After the treatment, the value decreased in all the patients, however there was not significant difference (p=0.0796). Six patients out of eight patients showed the progression of atherosclerosis, new plaque formation or progression of intima-media thickness by carotid artery ultrasonography. In evaluation of CAVI index, some patients showed the elevation of index with the progression of treatment. However, there was not significant elevation at all during the treatment.
Conclusion
We reported that malignant lymphoma patients showed the significant elevation of vWF during the R-CHOP therapy. We speculate that this therapy may be the risk of progression of atherosclerosis via vascular endothelial damage. Further study will be required to clarify the relationship between chemotherapy and arteriosclerosis.
Session topic: 35. Thrombosis and vascular biology & translational Research
Keyword(s): Atherosclerosis, Malignant lymphoma, Rituximab