Evaluating Cardiac Biomarkers after Chemotherapy and Proton Therapy for Mediastinal Hodgkin Lymphoma

Abstract

PURPOSE: Late cardiac complications from thoracic radiation of patients with Hodgkin lymphoma are of great concern. The authors investigated whether cardiac biomarkers could identify patients with early cardiac damage from thoracic radiation. MATERIALS AND METHODS: Following completion of anthracycline-based chemotherapy, 14 patients with stage I-IIIA mediastinal Hodgkin lymphoma were enrolled on an IRB-approved prospective trial and agreed to serum evaluation of troponin, CK-MB, and BNP before beginning radiation, after completing radiation, and every 3 to 6 months for 5 years, during follow-up or until relapse. RESULTS: Among the 14 patients, median follow-up for the entire cohort was 5 years. No evidence in abnormal values in troponin or CK-MB was observed among the patient cohort. BNP levels demonstrated statistically significant higher values at various follow-up time points. Higher levels of BNP were observed among patients receiving higher anthracycline doses (>250 mg), but not among patients with higher mean heart radiation doses. CONCLUSIONS: In the first 5 years after treatment, no rise in CK-MB or troponin was identified. BNP levels significantly increased following treatment, with larger increases among patients who received higher doses of anthracyclines. Further investigation is warranted. 目的：霍奇金淋巴瘤患者的胸腔辐射晚期心脏并发症具有很大的关注。作者调查了心脏生物标志物是否可以识别胸部辐射早期心脏损伤的患者。材料和方法：完成蒽环类化疗完成后，14例患有II-IIIA阶段纵隔霍奇金淋巴瘤的患者注册了IRB批准的前瞻性试验，并同意在开始辐射之前对肌钙蛋白，CK-MB和BNP进行血清评价，之后完成辐射，每3至6个月5年，在后续行动或直到复发期间。结果：14名患者中，整个队列的中位后续时间为5年。在患者队列中没有观察到肌钙蛋白或CK-MB异常值的证据。 BNP水平在各种后续时间点处展示了统计上显着的更高值。在接受较高的蒽环类剂量（> 250mg）的患者中观察到更高水平的BNP，但不含患有更高的心脏辐射剂量的患者。结论：在治疗后的前5年中，鉴定了CK-MB或肌钙蛋白的升高。在治疗后，BNP水平显着增加，接受较高剂量的蒽环植物的患者增加了较大的增加。进一步调查是有保证的。