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)
Sara Bringhen,
Alberto Milan,
Claudio Ferri,
Ralph Wäsch,
Francesca Gay,
Alessandra Larocca,
Marco Salvini,
Evangelos Terpos,
Hartmut Goldschmidt,
Michele Cavo,
Maria Teresa Petrucci,
Heinz Ludwig,
Holger W. Auner,
Jo Caers,
Martin Gramatzki,
Mario Boccadoro,
Hermann Einsele,
Pieter Sonneveld,
Monika Engelhardt
Affiliations
Sara Bringhen
Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Italy
Alberto Milan
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
Claudio Ferri
University of L’Aquila, MeSVA Department, San Salvatore Hospital, Division of Internal Medicine & Nephrology, Coppito, Italy
Ralph Wäsch
Department of Medicine I, Hematology, Oncology & Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Germany
Francesca Gay
Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Italy
Alessandra Larocca
Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Italy
Marco Salvini
Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Italy
Evangelos Terpos
Department of Clinical Therapeutics, University of Athens School of Medicine, Greece
Hartmut Goldschmidt
Medizinische Klinik, Abteilung Innere Medizin V, Universitätsklinikum Heidelberg und National Centrum für Tumorerkrankungen (NCT), Heidelberg, Germany
Michele Cavo
“Seràgnoli” Institute of Hematology and Medical Oncology, University of Bologna, Italy
Maria Teresa Petrucci
Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University of Rome, Italy
Heinz Ludwig
1. Medical Department and Oncology, Wilhelminenspital Wien, Austria
Holger W. Auner
Department of Medicine, Imperial College London, UK
Jo Caers
Department of Hematology, Domaine University, Liege, Belgium
Martin Gramatzki
Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Germany
Mario Boccadoro
Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Italy
Hermann Einsele
Department of Internal Medicine II, University Hospital of Würzburg, Germany
Pieter Sonneveld
Department of Hematology, Rotterdam, the Netherlands
Monika Engelhardt
Department of Medicine I, Hematology, Oncology & Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Germany
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.
