{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T15:59:51Z","timestamp":1792598391030,"version":"4.5.0"},"reference-count":57,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    The (R)-CDOP combination regimen, based on pegylated liposomal doxorubicin, is increasingly used for elderly patients with non-Hodgkin\u2019s lymphoma. However, the cardiotoxicity and efficacy of the (R)-CDOP regimen compared with conventional anthracyclines have not been demonstrated in the general population. Therefore, this systematic review and meta-analysis evaluated the risk of cardiotoxicity and efficacy associated with the (R)-CDOP regimen in patients with non-Hodgkin\u2019s lymphoma.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    PubMed, Embase, Cochrane Library, CNKI, WanFang Database, and VIP were searched. The search covered the period from the start of the clinical use of (R)-CDOP to April 2022. We searched the literature for cardiovascular adverse events associated with (R)-CDOP in non-Hodgkin\u2019s lymphoma. The data were analyzed using R 4.2.0 and Stata 12.0.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    From the included studies, the important findings were as follows: total cardiovascular event rate, 7.45% (95% confidence interval [CI] = 4.86%\u201310.44%); non-serious cardiovascular adverse event rate, 6.48% (95% CI = 3.70%\u20139.8%); serious cardiovascular adverse event rate, 0.67% (95% CI = 0.00%\u20132.12%); heart failure rate, 0.55% (95% CI = 0.00%\u20131.93%); rate of treatment discontinuation attributable to left ventricular dysfunction or heart failure, 0.02% (95% CI = 0.00%\u20130.57%); and cardiovascular death rate, 0.00% (95% CI = 0.00%\u20130.37%). Compared with the (R)-CHOP regimen, the (R)-CDOP regimen reduced the risk of cardiovascular events, including total cardiovascular adverse events (odds ratio [OR] = 0.161, 95% CI = 0.103\u20130.251,\n                    <jats:italic>p<\/jats:italic>\n                    &amp;lt; 0.001, and NNT = 3.7), non-serious cardiovascular adverse events (OR = 0.171, 95% CI = 0.093\u20130.314,\n                    <jats:italic>p<\/jats:italic>\n                    &amp;lt; 0.001, and NNT = 3.6), serious cardiovascular adverse events (OR = 0.252, 95% CI = 0.119\u20130.535,\n                    <jats:italic>p<\/jats:italic>\n                    &amp;lt; 0.001, and NNT = 6.8), and heart failure (OR = 0.294, 95% CI = 0.128\u20130.674,\n                    <jats:italic>p<\/jats:italic>\n                    = 0.004, and NNT = 9.5). To evaluate the survival benefits, we compared (R)-CDOP and (R)-CHOP regimens. We found that the (R)-CDOP regimen was no less efficacious, including complete remission (CR) (OR = 1.398, 95% CI = 0.997\u20131.960, and\n                    <jats:italic>p<\/jats:italic>\n                    = 0.052), partial response (PR) (OR = 1.631, 95% CI = 1.162\u20132.289, and\n                    <jats:italic>p<\/jats:italic>\n                    = 0.005), objective response rate (ORR) (OR = 2.236, 95% CI = 1.594\u20133.135, and\n                    <jats:italic>p<\/jats:italic>\n                    &amp;lt; 0.001), stable disease (SD) (OR = 0.526, 95% CI = 0.356\u20130.776, and\n                    <jats:italic>p<\/jats:italic>\n                    = 0.001), and progressive disease (PD) (OR = 0.537, 95% CI = 0.323\u20130.894, and\n                    <jats:italic>p<\/jats:italic>\n                    = 0.017).\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Our findings suggested that the (R)-CDOP regimen had a lower risk of cardiovascular adverse events in non-Hodgkin\u2019s lymphoma than the (R)-CHOP regimen, demonstrating its safety with regard to cardiotoxicity. In addition, this study found the (R)-CDOP regimen was no less efficacious than the (R)-CHOP regimen in the treatment of non-Hodgkin\u2019s lymphoma. These findings need to be validated by higher-quality research because of the limited number and quality of included studies.\n                  <\/jats:p>","DOI":"10.3389\/fphar.2022.1060668","type":"journal-article","created":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T14:16:29Z","timestamp":1669904189000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Cardiovascular adverse events associated with cyclophosphamide, pegylated liposomal doxorubicin, vincristine, and prednisone with or without rituximab ((R)-CDOP) in non-Hodgkin\u2019s lymphoma: A systematic review and meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Bin","family":"Lu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Longfei","family":"Shen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jia","family":"Qi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhihao","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lu","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ming","family":"Zhong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,12,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"261","DOI":"10.1002\/hon.2607","article-title":"Cardiovascular mortality among patients with non-Hodgkin lymphoma: Differences according to lymphoma subtype","volume":"37","author":"Abuamsha","year":"2019","journal-title":"Hematol. 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