The RESILIENCE trial has expanded its inclusion criteria to allow more types of lymphoma to be included in the trial. These changes are proposed after having agreed with the recruiting hospitals. To date, only patients with a specific type of lymphoma (non-Hodgkin) were included, but after a careful study by the research team, it has been concluded that any type of lymphoma receiving anthracyclines is at risk of developing cardiotoxicity and therefore could benefit from remote ischemic conditioning. Furthermore, this change will increase the rate of recruitment by having more candidate patients who may meet the inclusion criteria and may benefit from this trial.
Until now, only non-Hodgkin lymphomas were candidates for this trial. The original reason for restricting this type of lymphoma was that they tend to be middle-advanced age patients. However, there are features other than age that increase the risk of anthracycline cardiac toxicity, and they may exist in patients of all ages and with other types of lymphoma receiving anthracycline therapy. We believe that any lymphoma receiving the protocol-specified number of chemotherapy cycles (carrying some risk of cardiac toxicity) should be a candidate for this trial. The justification in both cases is the treatment scheme (including anthracyclines), which is very similar between the two. Patients with Hodgkin lymphoma who have some risk criteria for developing cardiotoxicity would also be likely to benefit from preventive therapy such as remote ischemic conditioning (RIC). There is no medical or scientific reason not to include patients with any type of lymphoma who meet the rest of the inclusion and exclusion criteria.
This review has been used to refine some other inclusion and exclusion criteria, and to make the trial as large as possible so that a greater number of patients are potential candidates to participate in it.