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

  • Dae Hyun Lee
  • Michael G. Fradley
Cardio-oncology (M Fradley, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Cardio-oncology


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.


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.


Proteasome inhibitors Immunomodulatory drugs Cardiotoxicity Cardio-oncology Multiple myeloma Carfilzomib Bortezomib Thalidomide Lenalidomide 


Compliance with Ethical Standards

Conflict of Interest

Dae Hyun Lee declares no potential conflicts of interest.

Michael G. Fradley is a section editor for Current Treatment Options in Cardiovascular Medicine.

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.

References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Internal MedicineUniversity of South FloridaTampaUSA
  2. 2.Department of Cardiovascular SciencesUniversity of South FloridaTampaUSA
  3. 3.Cardio-Oncology ProgramH. Lee Moffitt Cancer Center and Research InstituteTampaUSA

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