title: Beyond Anthracyclines: Preemptive Management of Cardiovascular Toxicity in the Era of Targeted Agents for Hematologic Malignancies.
abstract: Advances in drug discovery have led to the use of effective targeted agents in the treatment of hematologic malignancies. Drugs such as proteasome inhibitors in multiple myeloma and tyrosine kinase inhibitors in chronic myeloid leukemia and non-Hodgkin lymphoma have changed the face of treatment of hematologic malignancies. There are several reports of cardiovascular adverse events related to these newer agents. Both "on-target" and "off-target" effects of these agents can cause organ-specific toxicity. The need for long-term administration for most of these agents requires continued monitoring of toxicity. Moreover, the patient population is older, often over 50 years of age, making them more susceptible to cardiovascular side effects. Additional factors such as prior exposure to anthracyclines often add to this toxicity. In light of their success and widespread use, it is important to recognize and manage the unique side effect profile of targeted agents used in hematologic malignancies. In this article, we review the current data for the incidence of cardiovascular side effects of targeted agents in hematologic malignancies and discuss a preemptive approach towards managing these toxicities.
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, 3927 The Vanderbilt Clinic, Nashville, TN, USA.
authors.forename: Tarsheen K
authors.initials: TK
authors.lastname: Sethi
authors.affiliation: Division of Internal Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Basak
authors.initials: B
authors.lastname: Basdag
authors.affiliation: Division of Cardiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Nirmanmoh
authors.initials: N
authors.lastname: Bhatia
authors.affiliation: Division of Cardiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
authors.forename: Javid
authors.initials: J
authors.lastname: Moslehi
authors.affiliation: Division of Hematology/Oncology, Department of Medicine, Vanderbilt University Medical Center, 3927 The Vanderbilt Clinic, Nashville, TN, USA. nishitha.reddy@vanderbilt.edu.
authors.forename: Nishitha M
authors.initials: NM
authors.lastname: Reddy
mesh_terms: D000818:Animals; D018943:Anthracyclines / Q000009:adverse effects* / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D066126:Cardiotoxicity / Q000517:prevention & control; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000209:etiology* / Q000517:prevention & control / Q000628:therapy; D019468:Disease Management; D004353:Drug Evaluation, Preclinical; D019337:Hematologic Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000209:etiology; D006801:Humans; D058990:Molecular Targeted Therapy / Q000009:adverse effects*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D018943:Anthracyclines; D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors
keywords: Cardiotoxicity; Non-anthracyclines; Novel agents