Cardiovascular and Thrombotic Complications of Novel Multiple Myeloma Therapies: A Review

JAMA Oncol. 2017 Jul 1;3(7):980-988. doi: 10.1001/jamaoncol.2016.3350.

Abstract

Importance: Multiple myeloma (MM) is the second most common hematological malignant abnormality. The introduction of immunomodulatory drugs (IMiDs) and proteasome inhibitors (PIs) has greatly improved the overall survival of patients with MM. Prevention and treatment of cardiovascular and thrombotic issues associated with novel MM therapies have emerged as important aspects of supportive care in patients with MM.

Observations: We searched PubMed and the Cochrance database for studies published from March 2001 to January 2016. Emerging evidence suggests that both IMiDs and PIs can have cardiovascular (CV) sequelae, which include thromboembolic complications, cardiac, and vascular toxic effects. These complications occur against the backdrop of a high prevalence of CV disease in the MM population as well as the adverse cardiac and vascular effects of MM itself.

Conclusions and relevance: This review provides an overview of the incidences, clinical presentations, and mechanisms of CV complications in the MM population. We conclude that more research is needed for better screening and preventive strategies to abrogate these toxic effects and improve patient care.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents / adverse effects
  • Antineoplastic Agents / therapeutic use
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology
  • Humans
  • Immunologic Factors / adverse effects
  • Immunologic Factors / therapeutic use*
  • Lenalidomide
  • Multiple Myeloma / drug therapy*
  • Proteasome Inhibitors / adverse effects
  • Proteasome Inhibitors / therapeutic use*
  • Risk Factors
  • Thalidomide / adverse effects
  • Thalidomide / analogs & derivatives
  • Thalidomide / therapeutic use
  • Thromboembolism / epidemiology
  • Thrombosis / epidemiology
  • Thrombosis / etiology

Substances

  • Antineoplastic Agents
  • Immunologic Factors
  • Proteasome Inhibitors
  • Thalidomide
  • Lenalidomide