Recurrent cardiotoxicity potentiated by the interaction of proteasome inhibitor and immunomodulatory therapy for the treatment of multiple myeloma

Summary Patients with multiple myeloma (MM) have improved treatment options, including immunomodulatory drugs (IMiDs) and proteasome inhibitors (PIs). Despite their efficacy, increased rates of cardiovascular (CV) complications occur in patients exposed to some of these therapies. While previous res...

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Bibliographic Details
Published in:British journal of haematology 2018-01, Vol.180 (2), p.271-275
Main Authors: Fradley, Michael G., Groarke, John D., Laubach, Jacob, Alsina, Melissa, Lenihan, Daniel J., Cornell, Robert F., Maglio, Michelle, Shain, Kenneth H., Richardson, Paul G., Moslehi, Javid
Format: Article
Language:English
Subjects:
Adult
Antineoplastic Agents, Immunological - administration & dosage
Antineoplastic Combined Chemotherapy Protocols - adverse effects
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Cardiotoxicity
cardio‐oncology
Complications
Dexamethasone
Electrocardiography
Female
Heart Diseases - diagnosis
Heart Diseases - etiology
Hematology
Humans
Immunomodulation
immunomodulatory drugs
Magnetic Resonance Imaging - methods
Multiple myeloma
Multiple Myeloma - complications
Multiple Myeloma - drug therapy
proteasome inhibitor
Proteasome inhibitors
Proteasome Inhibitors - administration & dosage
Side effects
Toxicity
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Summary:Summary Patients with multiple myeloma (MM) have improved treatment options, including immunomodulatory drugs (IMiDs) and proteasome inhibitors (PIs). Despite their efficacy, increased rates of cardiovascular (CV) complications occur in patients exposed to some of these therapies. While previous research has focused on identifying the toxicities inherent to each specific agent, the CV side effects may be potentiated by the combination of PIs and IMiDs plus dexamethasone. We present a patient with MM with recurrent cardiotoxicity only when exposed to combination PI and IMiD‐based therapy. We also review the literature in this context, and propose a potential algorithm for cardiotoxicity prevention in this population.
ISSN:0007-1048
1365-2141
DOI:10.1111/bjh.14970