Introduction: Patients with cancer have an increased risk of both venous and arterial thromboembolism (AT) (1). Aggressive lymphomas like the most common type - diffuse large B cell lymphoma (DLBCL) have a higher frequency of AT compared to indolent ones after diagnosis and during treatment (2,3). However there is little information about the frequency of AT such as myocardial infarction (MI) before the diagnosis of DLBCL. Aim: To determine the prevalence of MI in DLBCL before diagnosis.
Patients and Methods: We collected data retrospectively from DLBCL patients at the General Hospital Dr. Josip Benčević from the beginning of 2011 by August 2023.
Results: 59 DLBCL patients were included in this study, 33 (56%) female, median age 67 (range 28 to 82 years). Eight (13.6%) patients had MI before the DLBCL diagnosis, 6 male and 2 female. All eight patients who had a MI achieved a complete remission (CR) of the DLBCL after the planned treatment (4 patients treated with R CHOP and 4 with DA R EPOCH protocol). Seven patients are alive, with no signs of DLBCL, and 1 patient died 8 years after the end of treatment at the age of 84. The rate of CR in the entire study population was 83% after first line of treatment and 47 (63%) patients are still alive in CR. 6 patients died of DLBCL, 8 of infectious complications, while the cause of death for 8 patients is unknown. 2 patients had MI after diagnosis of DLBCL. One 5 years after the completion of chemotherapy and he previously had an MI, while the other patient developed an MI at the time of relapse of DLBCL.
Conclusions: Our study suggests a higher prevalence of IM in patients with DLBCL (13.6%) than in general population (3.8%) (4). Interestingly in our study is the fact that a previous MI did not negatively affect the outcome of treatment. The group of patients with a previous MI actually had a better survival compared to the entire study population. Further studies with more patients are needed to confirm this observation, and eventually to find a link between DLBCL and MI.