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Cardiovascular Complications Associated with Multiple Myeloma Therapies: Incidence, Pathophysiology, and Management

  • Vivek G. Patel
  • Robert F. CornellEmail author
Cardio-oncology (EH Yang, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Cardio-oncology

Abstract

Purpose of Review

Multiple myeloma is a common hematologic malignancy characterized by recurrent relapsing disease course requiring use of various therapies. Over the past few decades, significant advancements in the treatment of myeloma have occurred including routine use of proteasome inhibitors and immunomodulatory drugs. These have effectively improved survival; however, some also have increased risk of cardiovascular toxicity. Here, we will review the incidence, pathophysiology, and management of cardiovascular complications associated with antimyeloma agents.

Recent Findings

Cardiovascular complications associated with myeloma treatment are common. These cardiovascular complications include accelerated hypertension, ischemic heart disease, congestive heart failure, arrhythmia, pulmonary hypertension, venous thromboembolism, and arterial thromboembolism. Thromboprophylactic strategies during treatment with immunomodulatory agents and screening strategies to detect changes in myocardial function prior to the development of overt heart failure have occurred.

Summary

Cardiovascular complications associated with proteasome inhibitors and immunomodulatory drugs are an important component in supportive care of patients with myeloma. The incidence of cardiotoxicity is high, and, as such, early intervention and collaborative efforts between cardiologists and oncologists to mitigate and effectively manage these complications are imperative. Additional studies are needed to clarify the underlying pathophysiology and evaluate effective strategies for prevention and treatment.

Keywords

Cardiovascular complication Multiple myeloma Cardiotoxicity Immunomodulatory drug Proteasome inhibitor Relapsed myeloma Thrombotic complication Venous thromboembolism Heart failure Thromboprophylaxis 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Internal Medicine, Division of Hematology and OncologyVanderbilt University Medical CenterNashvilleUSA

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