Cardiac Involvement in Patients with Hematologic Malignancies

Abstract

Authors have reviewed literature about the management of patients with cardiologic disease occurring secondary to hematologic pathology itself or its therapy, with a focus on infiltration of myocardium in acute and chronic leukemia, lymphoma, multiple myeloma, and hypereosinophilic syndrome. Moreover, they evaluated chemotherapy-associated toxicity, particularly for new drugs such as monoclonal antibody therapy, tyrosine kinase inhibitors, arsenic trioxide, bortezomib, and epigenetic therapy. In fact, cardiac toxicity may range from asymptomatic subclinical abnormalities, such as electrocardiographic changes and left ventricular ejection decline, to life-threatening events and lead to chemotherapy dose reduction and delay and, in some cases, for patients with severe side effects, discontinuation of treatment. Finally, they discussed on the identification of early markers of cardiac injury and on cardiac stem cell therapy as a promising approach to facilitate myocardial regeneration.

Long-term Cardiovascular Toxicity in Children, Adolescents, and Young Adults Who Receive Cancer Therapy: Pathophysiology, Course, Monitoring, Management, Prevention, and Research Directions

“…48 Arsenic trioxide is highly efficacious in treatment of both newly diagnosed and relapsed acute promyelocytic leukemia; however, a number of studies describe the occurrence of cardiotoxicity when this drug is used in children. [49][50][51][52] Tyrosine Kinase Inhibitors. Tyrosine kinase inhibitors such as dasatinib, lapatinib, imatinib, and nilotinib have been implicated in prolonging the QT interval in adults, with an incidence of 1% to 10%.…”

Cardiac disease in a case of precursor B acute lymphoblastic leukaemia with eosinophilia(ALL/Eo)

“…Cardio toxicity of chemotherapeutic drugs, heart failure and precipitated coronary events are typical examples 12 13. Moreover, opportunistic infections such as fungi may invade the cardiac chambers 14.…”

Leukemic Involvement in the Thorax

“…Chemotherapeutic agents used in the treatment of leukemia can induce cardiac toxic effects. For example, authors of several studies have reported that the TKI imatinib may be associated with congestive heart failure (44). Manifestations of chemotherapy-induced cardiac toxic effects are variable and include congestive heart failure, cardiomyopathy, and pericarditis (44).…”