Vascular toxicity associated with antineoplastic agents

Area of Science:

• Oncology
• Pharmacology
• Vascular Medicine

Background:

• Vascular disorders are observed following antineoplastic agent administration.
• The exact cause of these vascular issues (chemotherapy, malignancy, or other factors) remains unclear.
• Specific chemotherapy agents are linked to distinct vascular toxicities.

Purpose of the Study:

• To review and summarize the known vascular disorders associated with chemotherapy.
• To highlight specific drug-toxicity relationships.
• To discuss potential preventive strategies for severe complications like hepatic veno-occlusive disease (HVOD).

Main Methods:

• Literature review of reported vascular complications from antineoplastic agents.
• Identification of specific chemotherapy drugs and their associated vascular toxicities.
• Discussion of emerging preventive measures for bone marrow transplantation complications.

Main Results:

• Cisplatin, bleomycin, and vinblastine are associated with Raynaud's phenomenon.
• 5-fluorouracil and high-dose cytarabine can cause painful acral erythema.
• Mitomycin is a common cause of thrombotic microangiopathic syndrome.
• Hepatic Veno-Oclusive Disease (HVOD) is a significant toxicity of bone marrow transplantation protocols.
• Pentoxifylline and low-dose heparin show promise in preventing HVOD.
• Chemotherapy regimens for breast cancer may be linked to thrombotic events.

Conclusions:

• A causal relationship exists between certain chemotherapies and specific vascular disorders.
• Preventing chemotherapy-induced vascular toxicity, particularly HVOD, requires further investigation.
• Prospective studies are necessary to confirm the link between chemotherapy and thrombotic events in breast cancer patients.
• Elucidating the pathogenesis of chemotherapy-related vascular toxicity is crucial for patient management.