High Sensitivity Troponin T as Complementary Modality for Determining Doxorubicin Regimen Cardiotoxicity in Non-Hodgkin Lymphoma Patients

Abstract

Purpose: This study aims to evaluate the role of high-sensitivity troponin T (hsTnT) as acomplementary tool for determining cardiotoxicity in non-Hodgkin lymphoma (NHL) patientsreceiving cyclophosphamide, doxorubicin, vincristine and prednisone (CHOP) regimenchemotherapy.Methods: We included 35 patients diagnosed with NHL who received CHOP chemotherapy.Left ventricular ejection fraction (LVEF) and hsTnT were measured at two time points: beforethe first cycle (pre-test) and after the fourth cycle (post-test). The LVEF and hsTnT were analysedusing IBM SPSS version 24 through the paired-sample t test, Wilcoxon signed-rank test, Pearson’scorrelation and Spearman’s correlation.Results: There was a significant difference in both LVEF and hsTnT between pre-chemotherapyand post-4th chemotherapy cycles (P = 0.001). However, more contrast difference fromthe baseline value of hsTnT compared to LVEF could be observed. LVEF did not detect anydeterioration in myocardial function. However, 10 out of 35 subjects exhibit hsTnT higher thanthe 99th percentile of the population (> 14 pg/mL), suggesting that myocardial injury (MI) couldbe detected. There was no correlation between LVEF and hsTnT (P > 0.05).Conclusion: HsTnT, together with LVEF, could complement each other and offer better coveragefor detecting cardiotoxicity during the administration of CHOP in NHL patients. An insignificantcorrelation between hsTnT and LVEF showed that cardiotoxicity existed in a broad spectrumincluding cellular damage and functional impairment, as hsTnT represents cellular damage,and LVEF reflects heart functional capacity.

Keywords: Cardiotoxicity, Doxorubicin, Left ventricular function, Non-Hodgkin lymphoma, Troponin T, Cancer