摘要
简介:恶性血液病患者的抗肿瘤治疗中的抗肿瘤药物影响到心血管系统,其心脏毒性的发生率不断地增高。 方法:在本综述里,我们分析了现有的评价用于治疗恶性血液病的主要药物与相关的心脏毒性的可能性的文献。 结果:优化有心脏毒性风险的患者的早期鉴定是很有必要的。传统的超声心动图测量用于检测心脏的改变,如LVEF,缩短分数,直径和体积,只适用于心脏功能不全的后期诊断,可能已经不可逆转。对有快速进展成不可逆性心力衰竭风险的患者的早期鉴定有其主要目的,即他们有机会从早期预防和治疗措施中获益。有用的指向检测亚临床LVD的成像技术可能是斑点追踪超声心动图,与传统的左心室射血分数相比,已证明之前检测到的心肌收缩功能障碍。以这种观点,发现新的生物标志物,以确定患者发展这些并发症的高风险是另一重点。 结论:抗癌药物诱导的心脏毒性一直是几个并发因素影响的结果。无症状性功能失调先于临床症状是可信的。在无症状期,早期治疗可为病人心血管的“安全”状况做好准备;另一方面,后期或缺失的治疗发展成未来的心脏问题。
关键词: 心脏毒性,化疗、单克隆抗体、酪氨酸激酶、抗肿瘤药物、血液系统恶性肿瘤、心脏肿瘤。
Current Cancer Drug Targets
Title:Chemotherapy and Cardiotoxicity in Hematologic Malignancies
Volume: 17 Issue: 4
关键词: 心脏毒性,化疗、单克隆抗体、酪氨酸激酶、抗肿瘤药物、血液系统恶性肿瘤、心脏肿瘤。
摘要: Introduction: Antineoplastic agents affect the cardiovascular system, and the incidence of cardiotoxicity is continuously growing in patients with hematologic malignancies and treated with antineoplastic therapy.
Methods: In this mini-review, we analyzed existing literature which evaluates the likelihood of cardiotoxicity related to the main agents employed in the treatment of hematologic malignancies. Results: There is a significant need to optimize the early identification of patients who are at risk of cardiotoxicity. The conventional echocardiographic measurements used to detect cardiac alterations, such as LVEF, fractional shortening, diameters and volumes, allow only a late diagnosis of cardiac dysfunction, which might be already irreversible. The early identification of patients at risk for rapid progression towards irreversible cardiac failure has a primary purpose, the opportunity for them to benefit from early preventive and therapeutic measures. A useful imaging technique that points in this direction detecting subclinical LVD may be the speckle tracking echocardiography, that has demonstrated a previous detection of myocardial contractile dysfunction compared to the traditional left ventricular ejection fraction. In this view, the discovery of new biomarkers to identify patients at a high risk for the development of these complications is another priority. Conclusion: Cardiotoxicity induced by anticancer drugs is always the outcome of several concurrent factors. It is plausible that an asymptomatic dysfunction precedes clinical events. During this asymptomatic phase, an early treatment prepares the patient for cardiovascular “safety” conditions; on the other hand, a late or missing treatment paves the ground for the development of future cardiac events.Export Options
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Cite this article as:
Chemotherapy and Cardiotoxicity in Hematologic Malignancies, Current Cancer Drug Targets 2017; 17 (4) . https://dx.doi.org/10.2174/1568009617666161121141607
DOI https://dx.doi.org/10.2174/1568009617666161121141607 |
Print ISSN 1568-0096 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5576 |
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