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Applied Cardio-Oncology in Hematological Malignancies: A Narrative Review
Evdokia Mandala1, Kyranna Lafara1, Dimitrios Kokkinovasilis1
1Division of Hematology, Forth Department of Medicine, School of Medicine, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece.
Insights
Cardio-oncology manages heart issues in blood cancer patients. This review details therapy-related heart damage, risk, and detection methods for leukemia, lymphoma, and myeloma.
Area of Science:
- Cardio-oncology
- Hematology
- Cardiovascular Medicine
Background:
- Cardio-oncology integrates cardiovascular care for hematological malignancy patients.
- Therapy-related cardiotoxicity is a significant concern in treating blood cancers like leukemia, lymphoma, and multiple myeloma.
Purpose of the Study:
- To provide a comprehensive overview of cardiotoxicity in hematological malignancies.
- To detail the definition, risk stratification, and diagnostic approaches for therapy-related cardiac dysfunction.
Main Methods:
- Narrative review of current literature on cardiotoxicity in hematological cancers.
- Focus on multimodality imaging and cardiac biomarkers for early detection.
- Analysis of cardiotoxic profiles associated with various cancer therapies.
Main Results:
- Cardiotoxicity is a common complication of diverse hematological cancer treatments, including chemotherapy, immunotherapy, and stem cell transplantation.
- Early detection of myocardial dysfunction and electrical instability is crucial.
- Specific therapeutic agents and interventions carry distinct cardiotoxic risks.
Conclusions:
- Effective management of cardiotoxicity is essential for improving outcomes in patients with hematological malignancies.
- Multimodality imaging and biomarkers aid in risk stratification and monitoring.
- Understanding drug-specific cardiotoxicity profiles informs clinical practice and patient care.
Abstract:
Applied cardio-oncology in hematological malignancies refers to the integration of cardiovascular care and management for patients with blood cancer, particularly leukemia, lymphoma, and multiple myeloma. Hematological cancer therapy-related cardiotoxicity deals with the most common cardiovascular complications of conventional chemotherapy, targeted therapy, immunotherapy, chimeric antigen receptor T (CAR-T) cell and tumor-infiltrating lymphocyte therapies, bispecific antibodies, and hematopoietic stem cell transplantation. This narrative review focuses on hematological cancer-therapy-related cardiotoxicity's definition, risk stratification, multimodality imaging, and use of cardiac biomarkers to detect clinical and/or subclinical myocardial dysfunction and electrical instability. Moreover, the most common cardiotoxic profiles of the main drugs and/or therapeutic interventions in patients with hematological malignancies are described thoroughly.
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