Genetic predictors of cardiovascular toxicity in oncohematological patients

Aim . To identify single nucleotide polymorphisms reliably associated with cardiovascular toxicity in oncohematological patients receiving antitumor immunochemotherapy. Material and methods . For the study, 34 patients with an established diagnosis of non-Hodgkin's B-cell follicular lymphoma were prospectively selected at the Clinic of the Samara State Medical University, who were indicated for antitumor immunochemotherapy according to the R-CHOP protocol. During the follow-up, the patients were divided into 2 following groups: the main group consisted of 12 patients with cardiovascular toxicity (mean age, 42,4 (2,8) years, including men — n=3 (25%)), the control group — 22 patients without cardiovascular toxicity (mean age, 39,8 (1,7), including men — n=8 (36%)). Cardiovascular toxicity was verified on the basis of a combination of specific cardiological complaints with a decrease in the left ventricular ejection fraction >10% from the baseline or in absolute terms less than 53% and/or a decrease in the left ventricular longitudinal systolic strain >12% from the baseline and/or an increase in NT-proBNP >125 pg/ml. Results . The study presents the identified genetic features in oncohematological patients in the context of cardiovascular toxicity. ABCC5 rs1879257, PRKAG2 rs13224758, RYR2 rs10925391 and SLC22A7 rs414917 variants had a significant association with an increased risk of cardiovascular toxicity in the target group of patients by 5-6 times. In addition, the ABCB1 rs2032582 variant showed the opposite effect and was associated with a reduced risk of cardiovascular complications, having a protective effect on the cardiovascular system. Conclusion . Although further studies are needed to confirm the diagnostic and prognostic significance of the detected genetic variants, the study results indicate the prospects of genetic screening before antitumor immunochemotherapy as a future tool for stratifying oncohematological patients and minimizing cardiovascular toxicity.