We designed a prospective study to measure the left ventricular ejection fraction of 42 patients with non-Hodgkin lymphoma treated with Rituximab-based chemotherapy in a 1-h infusion. Our patients were not selected on the basis of their cardiac status. Cardiac history and other forms of co-morbidity were to be identified on entry. Before treatment, basal left ventricular ejection function (LVEF) was measured and every 6 months after treatment. Most patients were treated with CHOP-Rituximab combinations (79%). A drop in the post-treatment ejection fraction of over 10% from the pre-treatment base figure was found in 13 patients (31% of the total of the series, 39% of those receiving adriamycin-based chemotherapy). None of the patients without adriamycin had a decrease in LVEF. Three patients with drop >10% recovered normally, but when LVEF decreased by over 15%, which occurred in six patients (14.2%), none of them recovered normal level. Patients with normal systolic function had LVEF with a mean of 64.09 (+/-3.86) and patients with decreased systolic function had LVEF with a mean of 59.38 (+/-5.43). Though the data in this study suggest that rapid-infusion Rituximab does not cause relevant cardiac toxicity, there was a high percentage of reductions in LVEF of over 10%.
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