{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T22:06:33Z","timestamp":1776722793815,"version":"3.51.2"},"reference-count":12,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T00:00:00Z","timestamp":1772496000000},"content-version":"vor","delay-in-days":2,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rituximab, an anti-CD20 monoclonal antibody, is commonly used in the treatment of B-cell haematologic malignancies. Although caution is recommended in patients with underlying cardiovascular disease, its cardiotoxic potential\u2014particularly in relation to Takotsubo syndrome (TS)\u2014remains underrecognized compared to other agents such as trastuzumab. While rarely described in the literature, Takotsubo syndrome occurrence in association with rituximab administration may represent a serious adverse event that raises the question of safe chemotherapy rechallenge.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>We report the case of an 80-year-old woman with stage IV diffuse large B-cell lymphoma (DLBCL), who developed TS 48\u2005h after her first rituximab-containing chemotherapy (R-mini-CHOP). She presented with acute heart failure symptoms, elevated cardiac biomarkers, and echocardiographic findings of mid-septal hypokinesis and apical akinesis. Coronary angiography showed no obstructive lesions, and ventriculography confirmed TS. The patient was managed conservatively with diuretics and beta-blockers and showed progressive improvement. Follow-up echocardiography at one month demonstrated normalization of left ventricular ejection fraction (LVEF 68%) and recovery of function. Given the absence of cytokine release syndrome and the patient's clinical stability, rituximab was cautiously reintroduced. Two subsequent cycles of R-mini-CHOP were well tolerated. Due to disease progression, the chemotherapy regimen was later changed to etoposide and ifosfamide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>This case represents the fifth reported instance of rituximab-associated TS and the first to describe a successful rechallenge after recovery. With the increasing use of immunotherapies and recognition of their cardiovascular effects, clinicians must be aware of TS as a potential complication. When rechallenge is considered, individualized risk assessment and cardioprotective strategies are essential. This case also illustrates the importance of differentiating TS from other cardiotoxicities, such as anthracycline-induced cardiomyopathy, particularly in cancer patients with multiple cardiovascular risk factors.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytag145","type":"journal-article","created":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T12:24:29Z","timestamp":1772454269000},"source":"Crossref","is-referenced-by-count":1,"title":["Rechallenge of immunotherapy after rituximab-induced Takotsubo syndrome: a case report and review of the literature"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1585-5397","authenticated-orcid":false,"given":"Minh T\u00e2m","family":"Bailly","sequence":"first","affiliation":[{"name":"Department of Cardiology, Kremlin-Bic\u00eatre University Hospital, Assistance Publique-H\u00f4pitaux de Paris , 78 Rue du G\u00e9n\u00e9ral Leclerc, Le Kremlin-Bic\u00eatre, Paris 94270 ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudius","family":"Statescu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kremlin-Bic\u00eatre University Hospital, Assistance Publique-H\u00f4pitaux de Paris , 78 Rue du G\u00e9n\u00e9ral Leclerc, Le Kremlin-Bic\u00eatre, Paris 94270 ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Loic","family":"Renaud","sequence":"additional","affiliation":[{"name":"Department of Oncology, Gustave Roussy Institute, 114 rue Edouard Vaillant , 948000 Villejuif ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6574-5869","authenticated-orcid":false,"given":"Safwane","family":"El Hatimi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kremlin-Bic\u00eatre University Hospital, Assistance Publique-H\u00f4pitaux de Paris , 78 Rue du G\u00e9n\u00e9ral Leclerc, Le Kremlin-Bic\u00eatre, Paris 94270 ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrice","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Kremlin-Bic\u00eatre University Hospital, Assistance Publique-H\u00f4pitaux de Paris , 78 Rue du G\u00e9n\u00e9ral Leclerc, Le Kremlin-Bic\u00eatre, Paris 94270 ,","place":["France"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2026,3,3]]},"reference":[{"key":"2026032412251441200_ytag145-B1","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1016\/j.jaccao.2022.07.005","article-title":"Permissive cardiotoxicity: the clinical crucible of cardio-oncology","volume":"4","author":"Porter","year":"2022","journal-title":"JACC CardioOncol"},{"key":"2026032412251441200_ytag145-B2","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1038\/s41569-024-01017-x","article-title":"Cardiovascular disease and cancer: shared risk factors and mechanisms","volume":"21","author":"Wilcox","year":"2024","journal-title":"Nat Rev Cardiol"},{"key":"2026032412251441200_ytag145-B3","doi-asserted-by":"crossref","first-page":"1791","DOI":"10.1016\/S0140-6736(23)02705-8","article-title":"B-cell non-Hodgkin lymphomas","volume":"403","author":"Silkenstedt","year":"2024","journal-title":"Lancet"},{"key":"2026032412251441200_ytag145-B4","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1161\/CIRCULATIONAHA.117.031841","article-title":"Persistent long-term structural, functional, and metabolic changes after stress-induced (Takotsubo) cardiomyopathy","volume":"137","author":"Scally","year":"2018","journal-title":"Circulation"},{"key":"2026032412251441200_ytag145-B5","doi-asserted-by":"crossref","first-page":"18","DOI":"10.7861\/clinmed.22-4-s18","article-title":"Takotsubo cardiomyopathy or hidden cardiotoxic event by rituximab","volume":"22","author":"Min","year":"2022","journal-title":"Clin Med (Lond)"},{"key":"2026032412251441200_ytag145-B6","doi-asserted-by":"crossref","first-page":"875391","DOI":"10.3389\/fonc.2022.875391","article-title":"Takotsubo syndrome (TTS) in onco-hematologic patients: retrospective analysis and focus on the correlation or not with anticancer drugs. 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