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Cardiovascular Complications of Multiple Myeloma Treatment: Evaluation, Management, and Prevention

机译:多发性骨髓瘤治疗的心血管并发症:评估,管理和预防

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Abstract Purpose of review Multiple myeloma treatment regimens consist of proteasome inhibitors (bortezomib, carfilzomib, and ixazomib), immunomodulatory drugs (thalidomide, lenalidomide, and pomalidomide), and steroids. In this paper, we will review the pathophysiology and associated cardiotoxicities of the different multiple myeloma therapeutic modalities and present methods to mitigate the development of cardiovascular complications. Recent findings Although proteasome inhibitors and immunomodulatory drugs have led to significant improvements in oncologic outcomes, there is increasing evidence of serious cardiovascular side effects which may be exacerbated in the setting of underlying cardiovascular risk factors or disease. Cardiotoxicities include cardiomyopathy and heart failure, accelerated hypertension, arrhythmias, and both arterial and venous thromboembolism. Summary Given the frequency of cardiovascular risk factors in multiple myeloma patients as well as the cardiotoxicities associated with the different treatment regimens, it is essential to closely monitor these patients. Collaboration between cardiologists and oncologists is necessary to ensure patients receive optimal cancer treatment while minimizing cardiovascular risk.
机译:摘要审查多种骨髓瘤治疗方案的目的包括蛋白酶体抑制剂(Bortezomib,Carfilzomib和Ixazomib),免疫调节药物(沙利度胺,即苯二甲醛和氯脲醛)和类固醇。在本文中,我们将审查不同多发性骨髓瘤治疗方式的病理生理学和相关的心脏毒性,并提出的方法以减轻心血管并发症的发展。最近的发现虽然蛋白酶体抑制剂和免疫调节药导致肿瘤结果的显着改善,但增加了严重的心血管副作用的证据,这可能会在潜在的心血管危险因素或疾病方面加剧。心脏毒性包括心肌病和心力衰竭,加速高血压,心律失常和动脉和静脉血栓栓塞。发明内容鉴于多发性骨髓瘤患者的心血管危险因素的频率以及与不同治疗方案相关的心脏毒性,必须密切监测这些患者至关重要。心脏病学家和肿瘤科医师之间的协作是必要的,以确保患者在最小化心血管风险的同时获得最佳的癌症治疗。

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