Evidence map›Paper›PMID 40874400›Full record

SynthesisHematological oncology2025

Late Cardiac Toxicity After Anthracyclines and Radiotherapy for Lymphoma-A Regression Analysis of Dose-Response.

Lotte Nygård, Ivan Richter Vogelius, Klaus F Kofoed, Søren Bentzen, Lena Specht

Abstract readMeta-Analysis
In one paragraph

Synthesis in Hematological oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Lotte NygårdDepartment of Oncology, Section of Radiotherapy, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.ORCID https://orcid.org/0000-0003-0408-1007
Ivan Richter VogeliusDepartment of Oncology, Section of Radiotherapy, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
Klaus F KofoedFaculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
Søren BentzenDepartment of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, Maryland, USA.
Lena SpechtDepartment of Oncology, Section of Radiotherapy, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.ORCID https://orcid.org/0000-0002-6902-2190

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Late cardiac toxicity after radiation therapy and/or systemic therapy with anthracyclines for lymphomas is a serious concern. To estimate the risks with different treatment combinations, reliable estimates of the dose-response relationships are needed. We performed a literature-based regression analysis of long-term cardiac events after lymphoma treatment. The objective was to identify dose-response relationships for anthracycline and radiotherapy regarding congestive heart failure (CHF), ischemic heart disease (IHD), and valvular heart disease (VHD). We included papers published January 2000-December 2022 with data on long term cardiac outcomes in lymphoma patients, radiation doses to the heart, and anthracycline doses. Papers without dose/response information were excluded. We identified six eligible papers including 22,916 patients. The excess relative risk (ERR) of CHF for anthracyclines per 100 mg/m2 (corresponding to 2 cycles of ABVD or CHOP chemotherapy) was 92% (CI: 74%-101%), and for radiotherapy per Gray (Gy) of mean heart dose it was 6.1% (CI: 4.4%-7.6%). Corresponding numbers for the other endpoints were: IHD: No effect of anthracyclines, ERR = 4.4%/Gy (CI: 2.7%-6.1%) and VHD: ERR = 25%/100 mg/m2 (CI: 13%-37%) and ERR = 10%/Gy (CI: 6%-13%). Data agree with a linear no threshold dose-response relationship for related endpoints, that is, there are no "safe" lower doses of either anthracyclines or radiotherapy. Late cardiac toxicity risks for all three endpoints can be assessed in each patient by a combined estimate from the cumulative doses of anthracyclines and radiation to the heart. This estimate can guide future treatment allocation in lymphoma patients.

Indexed as

AnthracyclinesCardiotoxicityLymphomaDose-Response Relationship, DrugHumansRegression AnalysisAnthracyclinesanthracyclinesdose‐responselate cardiac toxicitylymphomaradiotherapy

Identifiers

PMID40874400
PMCPMC12392247

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.