Introduction: Antineoplastic agents affect the cardiovascular system, and the incidence of
cardiotoxicity is continuously growing in patients with hematologic malignancies and treated with
Methods: In this mini-review, we analyzed existing literature which evaluates the likelihood of cardiotoxicity
related to the main agents employed in the treatment of hematologic malignancies.
Results: There is a significant need to optimize the early identification of patients who are at risk of
cardiotoxicity. The conventional echocardiographic measurements used to detect cardiac alterations,
such as LVEF, fractional shortening, diameters and volumes, allow only a late diagnosis of cardiac
dysfunction, which might be already irreversible. The early identification of patients at risk for rapid
progression towards irreversible cardiac failure has a primary purpose, the opportunity for them to
benefit from early preventive and therapeutic measures. A useful imaging technique that points in
this direction detecting subclinical LVD may be the speckle tracking echocardiography, that has
demonstrated a previous detection of myocardial contractile dysfunction compared to the traditional
left ventricular ejection fraction. In this view, the discovery of new biomarkers to identify patients at
a high risk for the development of these complications is another priority.
Conclusion: Cardiotoxicity induced by anticancer drugs is always the outcome of several concurrent
factors. It is plausible that an asymptomatic dysfunction precedes clinical events. During this asymptomatic
phase, an early treatment prepares the patient for cardiovascular “safety” conditions; on the other
hand, a late or missing treatment paves the ground for the development of future cardiac events.