{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,3]],"date-time":"2025-12-03T03:31:19Z","timestamp":1764732679620},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2017,3,8]],"date-time":"2017-03-08T00:00:00Z","timestamp":1488931200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Anthracyclines (AC) are still undeniable drugs in lymphoma treatment, despite occasionally causing cardiotoxicity. Liposomal AC may reduce cardiotoxicity while retaining clinical efficacy; also, biomarker monitoring during chemotherapy allows early detection of cardiac damage, enabling strategies to prevent left ventricular ejection fraction (LVEF) deterioration.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>We conducted a prospective observational trial in a real-life population of lymphoma patients, combining advanced echocardiography and biomarkers (Troponin I [TnI]) for early detection of cardiotoxicity; we applied a prespecified policy to minimize cardiotoxicity, selecting patients with higher baseline risk to replace doxorubicin with nonpegylated liposomal doxorubicin (NPLD) and starting cardioprotective treatment when subclinical cardiotoxicity was detected.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Ninety-nine patients received \u22651 cycle of chemotherapy (39 with NPLD): 38 (NPLD\u2009=\u200934) were older than 65 years. At baseline, the NPLD subgroup had more cardiovascular risk factors and comorbidities than the doxorubicin subgroup. After treatment, echocardiographic parameters did not worsen in the NPLD subgroup; significant LVEF reduction occurred in two patients treated with doxorubicin. Over treatment course, TnI rises increased linearly in the doxorubicin subgroup but modestly in the NPLD subgroup. At doxorubicin doses &amp;gt;200 mg\/m2 the difference was statistically significant, with more TnI rises in the doxorubicin subgroup. NPLD-treated patients did not experience higher rates of grade 3\u20134 adverse events. Within the diffuse large B-cell lymphomas category, we observed similar rates of complete and overall responses between doxorubicin- and NPLD-treated patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>A comprehensive strategy to prevent, detect, and treat cardiotoxicity allows an optimal management of the lymphoma with low incidence of cardiac complications.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1634\/theoncologist.2016-0289","type":"journal-article","created":{"date-parts":[[2017,3,9]],"date-time":"2017-03-09T02:05:19Z","timestamp":1489025119000},"page":"422-431","source":"Crossref","is-referenced-by-count":23,"title":["Modern Management of Anthracycline-Induced Cardiotoxicity in Lymphoma Patients: Low Occurrence of Cardiotoxicity with Comprehensive Assessment and Tailored Substitution by Nonpegylated Liposomal Doxorubicin"],"prefix":"10.1093","volume":"22","author":[{"given":"Jacopo","family":"Olivieri","sequence":"first","affiliation":[{"name":"Clinica di Ematologia, Universit\u00e0 Politecnica delle Marche, Ancona, Italy"},{"name":"UOC Medicina Interna ed Ematologia Ospedale Generale di Zona, Civitanova Marche, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gian Piero","family":"Perna","sequence":"additional","affiliation":[{"name":"Cardiologia Subintensiva, Presidio \u201cG.M. Lancisi\u201d, Azienda Ospedaliero-Universitaria \u201cOspedali Riuniti\u201d di Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caterina","family":"Bocci","sequence":"additional","affiliation":[{"name":"Clinica di Ematologia, Universit\u00e0 Politecnica delle Marche, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Montevecchi","sequence":"additional","affiliation":[{"name":"Clinica di Ematologia, Universit\u00e0 Politecnica delle Marche, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Attilio","family":"Olivieri","sequence":"additional","affiliation":[{"name":"Clinica di Ematologia, Universit\u00e0 Politecnica delle Marche, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pietro","family":"Leoni","sequence":"additional","affiliation":[{"name":"Clinica di Ematologia, Universit\u00e0 Politecnica delle Marche, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guido","family":"Gini","sequence":"additional","affiliation":[{"name":"Clinica di Ematologia, Universit\u00e0 Politecnica delle Marche, Ancona, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2017,3,8]]},"reference":[{"issue":"3s","key":"2021122507534645500_onco12070-bib-0001","doi-asserted-by":"crossref","first-page":"e4","DOI":"10.4081\/hr.2011.s3.e4","article-title":"Anthracyclines: A cornerstone in the management of non-Hodgkin\u2019s lymphoma","volume":"3","author":"Luminari","year":"2011","journal-title":"Hematol Rep"},{"key":"2021122507534645500_onco12070-bib-0002","first-page":"33","article-title":"Adriamycin (NSC-123,127): A new antibiotic with antitumor activity","volume":"53","author":"Marco","year":"1969","journal-title":"Cancer Chemother Rep"},{"key":"2021122507534645500_onco12070-bib-0003","author":"NCCN Clinical Practice Guidelines in Oncology","year":"2015"},{"key":"2021122507534645500_onco12070-bib-0004","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1186\/1471-2407-10-337","article-title":"Cardiotoxicity of anthracycline agents for the treatment of cancer: Systematic review and meta-analysis of randomised controlled trials","volume":"10","author":"Smith","year":"2010","journal-title":"BMC Cancer"},{"key":"2021122507534645500_onco12070-bib-0005","doi-asserted-by":"crossref","first-page":"710","DOI":"10.7326\/0003-4819-91-5-710","article-title":"Risk factors for doxorubicin-induced congestive heart failure","volume":"91","author":"Von Hoff","year":"1979","journal-title":"Ann Intern Med"},{"key":"2021122507534645500_onco12070-bib-0006","doi-asserted-by":"crossref","first-page":"2869","DOI":"10.1002\/cncr.11407","article-title":"Congestive heart failure in patients treated with doxorubicin: A retrospective analysis of three trials","volume":"97","author":"Swain","year":"2003","journal-title":"Cancer"},{"key":"2021122507534645500_onco12070-bib-0007","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1093\/ehjci\/jeu192","article-title":"Expert consensus for multimodality imaging evaluation of adult patients during and after cancer therapy: A report from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. 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