Cardiovascular involvement in patients affected by multiple myeloma: a comprehensive review of recent advances

Expert Rev Hematol. 2021 Dec;14(12):1115-1128. doi: 10.1080/17474086.2021.2003704. Epub 2021 Nov 29.

Abstract

Introduction: Multiple Myeloma (MM) is hematological neoplasia originating from plasma cells, which accounts for almost 1% of all oncologic malignancies. The median age of patients at diagnosis is about 65 years old and over. In this age group, cardiovascular (CV) diseases often co-exist, increasing the risk of adverse events related to MM treatment. A comprehensive search on the main educational platforms was performed and high-quality original articles and reviews were included.

Areas covered: Patients affected by MM are at risk for heart failure, uncontrolled systemic hypertension, accelerated ischemic heart disease, arterial/venous thromboembolism, and arrhythmias. These complications may be due to the effects of chemotherapy on the CV system, which may play on preexisting risk factors, and amyloid deposition at cardiac level.

Expert opinion: This review provides an updated overview of the spectrum of CV diseases that may affect MM patients, highlighting possible treatment strategies according to the latest recommendations. Cooperation between onco-hematologist and cardiologist is crucial in managing this population, in particular for adequate risk assessment, early diagnosis of CV complications, and proper treatment.

Keywords: Multiple Myeloma; amyloidosis; cardio-oncology; cardiotoxicity; cardiovascular complications.

Publication types

  • Review

MeSH terms

  • Aged
  • Arrhythmias, Cardiac
  • Cardiovascular Diseases* / etiology
  • Humans
  • Hypertension*
  • Multiple Myeloma* / complications
  • Multiple Myeloma* / epidemiology
  • Multiple Myeloma* / therapy
  • Risk Factors