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Myeloid Neoplasms Meet Cardiovascular Epidemiology: A Call for Integrated Cardio-hematology Care
Haoyu Zhang1,2, Bogda Koczwara3, Xue Qin Yu1,2
1School of Public Health, The University of Sydney, Sydney, Australia.
Insights
Patients with myeloid neoplasms face a higher risk of cardiovascular disease (CVD) events compared to the general population. Further research is needed to understand these links and improve integrative care for cancer survivors.
Area of Science:
- Cardio-oncology
- Hematology
- Epidemiology
Background:
- Cardiovascular disease (CVD) is a major concern for cancer survivors.
- Myeloid neoplasms are associated with increased cardiovascular and cerebrovascular events.
Purpose of the Study:
- To discuss the biological and clinical links between myeloid neoplasms and CVD.
- To highlight challenges in CVD surveillance using administrative data.
Main Methods:
- Population-based cohort study.
- Analysis of cardiovascular and cerebrovascular events in patients with myeloid neoplasms versus the general population.
- Discussion of biological pathways and treatment toxicities.
Main Results:
- Significantly elevated incidence of cardiovascular and cerebrovascular events in myeloid neoplasm patients.
- Heterogeneity in CVD risk across different myeloid neoplasm subtypes.
- Identified limitations in administrative data for CVD surveillance.
Conclusions:
- Myeloid neoplasms are linked to increased CVD risk, necessitating further research.
- Challenges in CVD surveillance require methodological improvements.
- Integrated care strategies are needed for patients with myeloid neoplasms.
Abstract:
As cancer survivorship continues to improve, cardiovascular disease (CVD) has become an increasingly important competing cause of morbidity and mortality among cancer survivors. In their population-based cohort from Piedmont, Italy, Dr. Catalano and his team reported a significantly elevated incidence of cardiovascular and cerebrovascular events among patients with myeloid neoplasms compared with the general population, with heterogeneity across disease subtypes. This commentary discusses the biological and clinical links between myeloid neoplasms and CVD, emphasizing the multifactorial pathways of myeloid pathogenesis and treatment-related cardiovascular toxicity. It also highlights key methodologic challenges in CVD surveillance using administrative data, including incomplete capture of mild or outpatient events and limited lifestyle information. The study's comprehensive design underscores the value of linked population datasets in cardio-oncology research. Given the rarity of myeloid malignancies and the multifactorial etiology of CVD, together with the epidemiologic evidence presented in this study, further etiologic investigations followed by interventional research are warranted to inform the design of optimal integrative care strategies for patients with myeloid neoplasms. See related article by Catalano et al., p. 109.
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