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Haematologica. 2018 Sep;103(9):1422-1432. doi: 10.3324/haematol.2018.191288. Epub 2018 Jul 26.

Cardiovascular adverse events in modern myeloma therapy - Incidence and risks. A review from the European Myeloma Network (EMN) and Italian Society of Arterial Hypertension (SIIA).

Author information

1
Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Italy sarabringhen@yahoo.com.
2
Department of Medical Sciences, Internal Medicine and Hypertension Division, University of Torino, Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Italy; Rete Oncologica Piemontese, Italy.
3
University of L'Aquila, MeSVA Department, San Salvatore Hospital, Division of Internal Medicine & Nephrology, Coppito, Italy.
4
Department of Medicine I, Hematology, Oncology & Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Germany.
5
Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Italy.
6
Department of Clinical Therapeutics, University of Athens School of Medicine, Greece.
7
Medizinische Klinik, Abteilung Innere Medizin V, Universitätsklinikum Heidelberg und National Centrum für Tumorerkrankungen (NCT), Heidelberg, Germany.
8
"Seràgnoli" Institute of Hematology and Medical Oncology, University of Bologna, Italy.
9
Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University of Rome, Italy.
10
1. Medical Department and Oncology, Wilhelminenspital Wien, Austria.
11
Department of Medicine, Imperial College London, UK.
12
Department of Hematology, Domaine University, Liege, Belgium.
13
Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Germany.
14
Department of Internal Medicine II, University Hospital of Würzburg, Germany.
15
Department of Hematology, Rotterdam, the Netherlands.

Abstract

Cardiovascular disease in patients with multiple myeloma may derive from factors unrelated to the disease (age, diabetes, dyslipidemia, obesity, prior cardiovascular diseases), related to the disease (cardiac AL-amyloidosis, hyperviscosity, high-output failure, arteriovenous shunting, anemia, renal dysfunction) and/or related to anti-myeloma treatment (anthracyclines, corticosteroids, alkylating agents, immunomodulatory drugs, proteasome inhibitors). Good knowledge of cardiovascular events, effective dose reductions, prevention and management of early and late cardiovascular side effects of chemotherapeutic agents are essential in current clinical practice. Myeloma experts are obliged to carefully balance the efficacy and toxicity of drugs for each individual patient. This review summarizes current data and novel insights into cardiovascular adverse events of today's anti-myeloma treatment, focusing on carfilzomib, as a starting point for developing consensus recommendations on preventing and managing cardiovascular side effects in patients with multiple myeloma.

PMID:
30049825
PMCID:
PMC6119131
DOI:
10.3324/haematol.2018.191288
[Indexed for MEDLINE]
Free PMC Article

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