Department of Cardiovascular and Pulmonary Sciences, Catholic University of the Sacred Heart, Rome, Italy.
Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Expert Rev Hematol. 2021 Dec;14(12):1115-1128. doi: 10.1080/17474086.2021.2003704. Epub 2021 Nov 29.
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.
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.
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.
多发性骨髓瘤（MM）是一种起源于浆细胞的血液系统肿瘤，占所有恶性肿瘤的近 1%。诊断时患者的中位年龄约为 65 岁及以上。在这个年龄段，心血管（CV）疾病经常同时存在，增加了与 MM 治疗相关的不良事件的风险。在主要的教育平台上进行了全面的搜索，并纳入了高质量的原始文章和综述。
患有 MM 的患者有心力衰竭、未控制的系统性高血压、加速缺血性心脏病、动脉/静脉血栓栓塞和心律失常的风险。这些并发症可能是由于化疗对心血管系统的影响，这可能对先前存在的危险因素产生影响，以及心脏水平的淀粉样蛋白沉积。
这篇综述提供了一个关于可能影响 MM 患者的 CV 疾病谱的最新概述，强调了根据最新建议可能的治疗策略。肿瘤血液学家和心脏病专家之间的合作对于管理这一人群至关重要，特别是对于充分的风险评估、CV 并发症的早期诊断和适当的治疗。
