title: Cardiac non-Hodgkin's lymphoma: clinical characteristics and trends in survival.
abstract: OBJECTIVE
  The purpose of this study was to describe the clinical characteristics and outcomes in cardiac non-Hodgkin's lymphoma (NHL).
  
  
  METHODS
  A retrospective analysis of 94 cases of NHL with biopsy-proven cardiac involvement in PubMed between 1990 and 2015.
  
  
  RESULTS
  Among cases with cardiac involvement, diffuse large B-cell lymphoma was the most common histologic subtype (58%), followed by T-cell lymphoma (16%), Burkitt's lymphoma (9%), and small lymphocytic lymphoma (6%). Symptomatic heart failure was the most common clinical presentation (34%), and 20% of patients had no cardiac symptoms. Median survival was 3 months (range, 0-72) among all patients. Patients who presented with heart failure had inferior outcomes. Patients with primary, vs. secondary, cardiac involvement had a trend toward superior outcomes. Importantly, chemotherapy treatment was associated with a prolongation in median survival (18 vs. 1 month, HR 0.16, 95% CI, 0.47-0.54, P = 0.0003), and patients diagnosed in the chemo-immunotherapy era demonstrated a trend toward better outcomes. Median survival was not reached among patients with B-cell malignancies who were alive for 1 month after the diagnosis.
  
  
  CONCLUSIONS
  Pathologic lymphomatous involvement of cardiac tissue should be considered in the evaluation of patients with NHL. Durable remissions can be achieved in B-cell NHL with cardiac involvement, and thus, therapy should be considered in such cases.
authors.affiliation: Department of Internal Medicine, Oregon Health & Sciences University, Portland, OR, USA.
authors.forename: Max J
authors.initials: MJ
authors.lastname: Gordon
authors.affiliation: Pathology & Lab Medicine, VA Portland Health Care Systems, Portland, OR, USA.
authors.forename: Olga
authors.initials: O
authors.lastname: Danilova
authors.affiliation: Department of Internal Medicine, Oregon Health & Sciences University, Portland, OR, USA.|Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Stephen
authors.initials: S
authors.lastname: Spurgeon
authors.affiliation: Department of Internal Medicine, Oregon Health & Sciences University, Portland, OR, USA. danilov@ohsu.edu.|Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA. danilov@ohsu.edu.
authors.forename: Alexey V
authors.initials: AV
authors.lastname: Danilov
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D015897:Comorbidity; D005260:Female; D006338:Heart Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000401:mortality* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000209:etiology / Q000401:mortality / Q000628:therapy; D063868:Patient Outcome Assessment; D012189:Retrospective Studies; D055815:Young Adult
keywords: cardiac; extranodal; heart; non-Hodgkin's lymphoma; prognosis; treatment