1Department of Cardiovascular Diseases.
2Department of Pharmacy, and.
Blood. 2022 Mar 10;139(10):1501-1516. doi: 10.1182/blood.2019003893.
The prognosis of several lymphoid malignancies has improved through development of novel therapies, combination with traditional chemotherapies, and delineation of appropriate therapeutic sequencing. Toxicities that are arising because of prolonged or multiple sequential therapeutic interventions are becoming increasingly impactful. Among the broad spectrum of complications that patients with lymphoid malignancies may experience, cardiovascular toxicities are significant in terms of morbidity and mortality. The entire cardiovascular system can be affected, but cardiomyopathy, heart failure, and arrhythmias remain of greatest concerns with the use of anthracyclines, hematopoietic stem cell transplantation, and radiation therapy in patients with lymphoid malignancies. These aspects will be covered in this article within the framework of case-based discussions. Key to the management of cardiovascular complications in patients with lymphoid malignancies is awareness and preparedness across the cancer continuum. Baseline risk stratification helps to direct surveillance and early intervention efforts before, during, and after cancer therapy, which are paramount for the best possible outcomes. Along these lines, the overall goal is to enable the best possible therapies for lymphoid malignancies without the complications of clinically significant cardiovascular events.
通过开发新的治疗方法、与传统化疗相结合以及明确适当的治疗顺序，几种淋巴恶性肿瘤的预后已经得到改善。由于长期或多次序贯治疗干预而产生的毒性作用变得越来越具有影响力。在淋巴恶性肿瘤患者可能经历的广泛并发症中，心血管毒性在发病率和死亡率方面具有重要意义。整个心血管系统都可能受到影响，但心肌病、心力衰竭和心律失常仍然是使用蒽环类药物、造血干细胞移植和放射治疗治疗淋巴恶性肿瘤患者时最令人担忧的问题。本文将在基于案例讨论的框架内讨论这些方面。管理淋巴恶性肿瘤患者心血管并发症的关键是在癌症治疗全过程中保持认识和准备。基线风险分层有助于在癌症治疗之前、期间和之后指导监测和早期干预工作，这对于获得最佳结果至关重要。基于这些考虑，总体目标是在不发生临床显著心血管事件的情况下，为淋巴恶性肿瘤提供尽可能好的治疗方法。
