• Eileen Mary Boyle and Franck Morschhauser.
• Hôpital Claude Huriez, Service des maladies du sang , CHRU Lille, 59000 , France +0033 320 44 42 92 ; franck.morshhauser@chru-lille.fr.
• Expert Opin Drug Saf. 2015 Apr 1; 14 (4): 601-7.

IntroductionThe current treatment approach of high-grade non-Hodgkin lymphoma (NHL) relies to a large extent on anthracycline-based regimens yielding cure rates in ∼ 65 - 75% of patients. Despite being highly effective, these regimens are associated with significant long-term toxicity with a cumulative 10-year incidence of cardiovascular disease of 22%. Moreover, for the 25 - 35% of patients who fail first-line therapy there has been very little progress in terms of salvage regimens over the past 15 years. Re-treatment with anthracyclines-based regimens was, until now, not an option given the extensive cardiac toxicity of these agents. Pixantrone dimaleate (Pixantrone) is a novel anthracycline-like drug that offers an interesting alternative for the treatment of aggressive NHL.Areas CoveredThis article provides an overview of treatment-related cardiac toxicity in NHL, the pharmacology of Pixantrone and the evidence supporting its use in NHL.Expert OpinionPixantrone is a potential alternative agent with a favorable safety profile for the treatment of relapsed and refractory NHL patients. It might benefit from combinations strategies and further development in the elderly and frail population.

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