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REVIEW ARTICLE
Haematologica 2018 Volume 103(9):1422-1432
Sara Bringhen,1 Alberto Milan,2 Claudio Ferri,3 Ralph Wäsch,4 Francesca Gay,1 Alessandra Larocca,1 Marco Salvini,1 Evangelos Terpos,5 Hartmut Goldschmidt,6 Michele Cavo,7 Maria Teresa Petrucci,8 Heinz Ludwig,9 Holger W. Auner,10 Jo Caers,11 Martin Gramatzki,12 Mario Boccadoro,1 Hermann Einsele,13 Pieter Sonneveld14 and Monika Engelhardt4 on behalf of the European Hematology Association, the European Myeloma Network and the Italian Society of Arterial Hypertension
Correspondence:
sarabringhen@yahoo.com
Received: February 15, 2018. Accepted: June 5, 2018. Pre-published: July 26, 2018.
doi:10.3324/haematol.2018.191288
Check the online version for the most updated information on this article, online supplements, and information on authorship & disclosures: www.haematologica.org/content/103/9/1422
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Ferrata Storti Foundation
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)
1Myeloma Unit, Division of Hematology, University of Torino, Azienda Ospedaliero- Universitaria Città della Salute e della Scienza di Torino, Italy; 2Department 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; 3University of L’Aquila, MeSVA Department, San Salvatore Hospital, Division of Internal Medicine & Nephrology, Coppito, Italy; 4Department of Medicine I, Hematology, Oncology & Stem Cell Transplantation, Medical Center, Faculty of Medicine, University of Freiburg, Germany; 5Department of Clinical Therapeutics, University of Athens School of Medicine, Greece; 6Medizinische Klinik, Abteilung Innere Medizin V, Universitätsklinikum Heidelberg und National Centrum für Tumorerkrankungen (NCT), Heidelberg, Germany; 7“Seràgnoli” Institute of Hematology and Medical Oncology, University of Bologna, Italy; 8Hematology, Department of Cellular Biotechnologies and Hematology, Sapienza University of Rome, Italy; 91. Medical Department and Oncology, Wilhelminenspital Wien, Austria, 10Department of Medicine, Imperial College London, UK; 11Department of Hematology, Domaine University, Liege, Belgium; 12Division of Stem Cell Transplantation and Immunotherapy, University of Kiel, Germany; 13Department of Internal Medicine II, University Hospital of Würzburg, Germany and 14Department of Hematology, Rotterdam, the Netherlands
ABSTRACT
Cardiovascular disease in patients with multiple myeloma may derive from factors unrelated to the disease (age, diabetes, dyslipi- demia, obesity, prior cardiovascular diseases), related to the dis- ease (cardiac AL-amyloidosis, hyperviscosity, high-output failure, arterio- venous 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 manage- ment 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 con- sensus recommendations on preventing and managing cardiovascular side effects in patients with multiple myeloma.
Introduction
Multiple myeloma (MM) is a plasma cell dyscrasia accounting for 1% of neoplas- tic diseases. It typically affects the elderly population, with the median age at diag- nosis being 70 years.1,2 Cardiovascular disease is one of the most frequent comor- bidities in MM patients,3 being the main cause of death in western countries.4 Since
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