Drug-Related Cardiotoxicity for the Treatment of Haematological Malignancies in Elderly

Alessandra      Malato; Giorgia      Saccullo; Giovanni      Fazio; Beatrice      Vergara; Simona      Raso; Giovanni      Paolo Guarneri; Antonio      Russo; Vincenzo      Abbadessa; Sergio      Siragusa

Abstract

Several publications have focused on the cardiotoxicity of specific classes of haematological therapeutic agents such as antracyclines and cyclofosfamide. Cardiotoxicity of cancer chemotherapeutics is a problem for patients of all ages, but it increases with age. Toxicity can also be developed months after the last chemotherapy dose, and late reactions can be seen years later when they present new-onset cardiomyopathy. No data are available about the cardiotoxicity of non-chemotherapy agents currently used as preferred therapy for haematological malignancy in elderly. In this review we have provided a summary of the cardiovascular toxic effects produced by different drugs and therapeutic agents. Early identification of patients who are at risk for cardiotoxicity should be a primary goal for haematologists in the development of personalised antineoplastic therapeutic strategies or interventions. Thus, the discovery of new biomarkers to identify patients at a high risk for the development of these complications is a high priority. Although targeted therapies such as imatinib and anti-CD20 antibody, such as rituximab, are considered less toxic and better tolerated by patients compared with classic chemotherapy drugs, certain cardiological complications can be very serious as these agents have been in use for a limited period of time.

Keywords: Haematological malignancies, cardiotoxicity, heart failure, imatinib, rituximab, antracyclines, cyclofosfamide, cardiomyopathy, electrocardiographic, left ventricular dysfunction, congestive heart failure, tyrosine-kinase, leukaemia, lymphoma, myeloma, antineoplastic, Stem Cell Transplantation, analogous chemotherapy, lymphoid neoplasm, Anthracyclines, sarcoma, breast cancer, Oedema, dyspnea, Hodgking lymphoma, Doxorubicin, vincristine, prednisone chemotherapy, regimen, B-Cell Non-Hodgkin's Lymphoma, neutropenia, ethylenediamintetraacetic acid, Cyclophosphamide, myeloablative, echocardiogram, protooncogene, oncovin, prednisone, tumour necrosis, complete atrioventricular block, mantle cell lymphoma, pyrexia, coronary stenoses, imatinib mesyllate, Bortezomib, chronic myeloid leukaemia, Thalidomide, Lenalidomide, Pomalidomide, antiangiogenesis, bradycardia, idiopathic dilated car-diomyopathy, thalidomide increases LVEF, thromboembolism, myelodysplastic syndrome, Immunomudulatory drugs, troponin T, brain