Rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) therapy increases carotid intima-media thickness and plaque score with von Willebrand factor activity elevation in patients with malignant lymphoma

Abstract

An increased risk for atherosclerosis has been noted in cancer survivors; however, studies that focus on the risk of atherosclerosis in patients treated with chemotherapy are scarce. Therefore, we evaluated 32 patients who received rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP) therapy for B-cell malignant lymphoma by analysing the changes in atherosclerosis. Just before each treatment course, plasma levels of von Willebrand Factor (vWF) activity were evaluated, and carotid ultrasonography was performed at baseline and after the final treatment. Throughout the follow-up period, plasma vWF levels showed significantly transient increased by approximately 20%–40%. Both mean carotid intima-media thickness (IMT) and plaque score (PS) significantly increased during the 36.6 ± 26.0 weeks of observation (mean IMT: 0.724 ± 0.118 to 0.767 ± 0.129 mm; PS: 4.31 ± 3.53 to 4.87 ± 3.88, P < 0.001). Our study suggests that R-CHOP therapy promotes atherosclerosis.

Keywords:

• B-cell malignant lymphoma
• atherosclerosis
• von Willebrand factor
• intima-media thickness
• plaque score
• chemotherapy

Acknowledgment

The authors would like to thank MARUZEN-YUSHODO for language review.

Disclosure statement

No potential conflict of interest was reported by the authors.

Author’s contributions

Conceptualization, design and writing—original draft preparation, N.S; data analysis, D.N., C.N. and N.S.; critical discussion of the results, Y.W., T.Y., S.N., M.O., A.S., H.O., S.Y., K.A. and I.T. All authors have read and agreed to the published version of the manuscript.