Carfilzomib-Based Regimen and Cardiotoxicity in Multiple Myeloma: Incidence of Cardiovascular Events and Organ Damage in Carfilzomib-Dexamethasone versus Carfilzomib-Lenalidomide-Dexamethasone. A Real-Life Prospective Study
Carfilzomib-mediated cardiotoxicity in multiple myeloma (MM) is a well-established adverse effect, however limited data are available on the comparison of cardiovascular complications in patients treated with Carfilzomib-dexamethasone (target dose of K 56 mg/m<sup>2</sup>) versus Carfilz...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/15/3/955 |
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| author | Anna Astarita Giulia Mingrone Lorenzo Airale Marco Cesareo Anna Colomba Cinzia Catarinella Dario Leone Francesca Gay Sara Bringhen Franco Veglio Alberto Milan Fabrizio Vallelonga |
| author_facet | Anna Astarita Giulia Mingrone Lorenzo Airale Marco Cesareo Anna Colomba Cinzia Catarinella Dario Leone Francesca Gay Sara Bringhen Franco Veglio Alberto Milan Fabrizio Vallelonga |
| author_sort | Anna Astarita |
| collection | DOAJ |
| description | Carfilzomib-mediated cardiotoxicity in multiple myeloma (MM) is a well-established adverse effect, however limited data are available on the comparison of cardiovascular complications in patients treated with Carfilzomib-dexamethasone (target dose of K 56 mg/m<sup>2</sup>) versus Carfilzomib-lenalidomide-dexamethasone (target dose of K 27 mg/m<sup>2</sup>) beyond controlled trials. A total of 109 patients were enrolled, 47 (43%) received Kd and 62 (57%) KRd. They then underwent a baseline and follow-up evaluation including trans-thoracic echocardiography and arterial stiffness estimation. All types of cardiovascular and hypertensive events occurred more frequently in the Kd group compared with the KRd (59% vs. 40% and 55% vs. 35.5% patients, respectively, <i>p</i> ≤ 0.05), with higher incidence of hypertensive. The time of onset of any type of CVAE, and of major and hypertensive events was shorter in the Kd regimen (<i>p</i> ≤ 0.05). At follow-up, Kd patients more frequently developed signs of cardiac (decline of global longitudinal strain) and vascular organ damage (rise of pulse wave velocity), as compared with KRd. Despite the older age, longer history of MM and longer period of pre-treatment of Kd patients, these factors did not increase the probability of incidence for all types of cardiovascular events at multivariate analysis (<i>p</i> > 0.05). In conclusion, the Kd regimen showed greater cardiovascular toxicity and earlier onset of events with respect to KRd. Thus, a closer and thorough follow-up should be considered. |
| first_indexed | 2024-03-11T09:50:32Z |
| format | Article |
| id | doaj.art-deb4533a443a4016b6ea99ce31b60090 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-11T09:50:32Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-deb4533a443a4016b6ea99ce31b600902023-11-16T16:19:40ZengMDPI AGCancers2072-66942023-02-0115395510.3390/cancers15030955Carfilzomib-Based Regimen and Cardiotoxicity in Multiple Myeloma: Incidence of Cardiovascular Events and Organ Damage in Carfilzomib-Dexamethasone versus Carfilzomib-Lenalidomide-Dexamethasone. A Real-Life Prospective StudyAnna Astarita0Giulia Mingrone1Lorenzo Airale2Marco Cesareo3Anna Colomba4Cinzia Catarinella5Dario Leone6Francesca Gay7Sara Bringhen8Franco Veglio9Alberto Milan10Fabrizio Vallelonga11Hypertension Unit, Department of Medical Sciences, Division of Internal Medicine, AO “Città Della Salute e Della Scienza” University Hospital, 10126 Turin, ItalyHypertension Unit, Department of Medical Sciences, Division of Internal Medicine, AO “Città Della Salute e Della Scienza” University Hospital, 10126 Turin, ItalyHypertension Unit, Department of Medical Sciences, Division of Internal Medicine, AO “Città Della Salute e Della Scienza” University Hospital, 10126 Turin, ItalyHypertension Unit, Department of Medical Sciences, Division of Internal Medicine, AO “Città Della Salute e Della Scienza” University Hospital, 10126 Turin, ItalyHypertension Unit, Department of Medical Sciences, Division of Internal Medicine, AO “Città Della Salute e Della Scienza” University Hospital, 10126 Turin, ItalyHypertension Unit, Department of Medical Sciences, Division of Internal Medicine, AO “Città Della Salute e Della Scienza” University Hospital, 10126 Turin, ItalyHypertension Unit, Department of Medical Sciences, Division of Internal Medicine, AO “Città Della Salute e Della Scienza” University Hospital, 10126 Turin, ItalyMyeloma Unit, Department of Medical Sciences, Division of Hematology, AO “Città Della Salute e Della Scienza” University Hospital, 10126 Turin, ItalyMyeloma Unit, Department of Medical Sciences, Division of Hematology, AO “Città Della Salute e Della Scienza” University Hospital, 10126 Turin, ItalyHypertension Unit, Department of Medical Sciences, Division of Internal Medicine, AO “Città Della Salute e Della Scienza” University Hospital, 10126 Turin, ItalyHypertension Unit, Department of Medical Sciences, Division of Internal Medicine, AO “Città Della Salute e Della Scienza” University Hospital, 10126 Turin, ItalyHypertension Unit, Department of Medical Sciences, Division of Internal Medicine, AO “Città Della Salute e Della Scienza” University Hospital, 10126 Turin, ItalyCarfilzomib-mediated cardiotoxicity in multiple myeloma (MM) is a well-established adverse effect, however limited data are available on the comparison of cardiovascular complications in patients treated with Carfilzomib-dexamethasone (target dose of K 56 mg/m<sup>2</sup>) versus Carfilzomib-lenalidomide-dexamethasone (target dose of K 27 mg/m<sup>2</sup>) beyond controlled trials. A total of 109 patients were enrolled, 47 (43%) received Kd and 62 (57%) KRd. They then underwent a baseline and follow-up evaluation including trans-thoracic echocardiography and arterial stiffness estimation. All types of cardiovascular and hypertensive events occurred more frequently in the Kd group compared with the KRd (59% vs. 40% and 55% vs. 35.5% patients, respectively, <i>p</i> ≤ 0.05), with higher incidence of hypertensive. The time of onset of any type of CVAE, and of major and hypertensive events was shorter in the Kd regimen (<i>p</i> ≤ 0.05). At follow-up, Kd patients more frequently developed signs of cardiac (decline of global longitudinal strain) and vascular organ damage (rise of pulse wave velocity), as compared with KRd. Despite the older age, longer history of MM and longer period of pre-treatment of Kd patients, these factors did not increase the probability of incidence for all types of cardiovascular events at multivariate analysis (<i>p</i> > 0.05). In conclusion, the Kd regimen showed greater cardiovascular toxicity and earlier onset of events with respect to KRd. Thus, a closer and thorough follow-up should be considered.https://www.mdpi.com/2072-6694/15/3/955carfilzomibcardiotoxicityKdKRdreal-lifedexamethasone |
| spellingShingle | Anna Astarita Giulia Mingrone Lorenzo Airale Marco Cesareo Anna Colomba Cinzia Catarinella Dario Leone Francesca Gay Sara Bringhen Franco Veglio Alberto Milan Fabrizio Vallelonga Carfilzomib-Based Regimen and Cardiotoxicity in Multiple Myeloma: Incidence of Cardiovascular Events and Organ Damage in Carfilzomib-Dexamethasone versus Carfilzomib-Lenalidomide-Dexamethasone. A Real-Life Prospective Study Cancers carfilzomib cardiotoxicity Kd KRd real-life dexamethasone |
| title | Carfilzomib-Based Regimen and Cardiotoxicity in Multiple Myeloma: Incidence of Cardiovascular Events and Organ Damage in Carfilzomib-Dexamethasone versus Carfilzomib-Lenalidomide-Dexamethasone. A Real-Life Prospective Study |
| title_full | Carfilzomib-Based Regimen and Cardiotoxicity in Multiple Myeloma: Incidence of Cardiovascular Events and Organ Damage in Carfilzomib-Dexamethasone versus Carfilzomib-Lenalidomide-Dexamethasone. A Real-Life Prospective Study |
| title_fullStr | Carfilzomib-Based Regimen and Cardiotoxicity in Multiple Myeloma: Incidence of Cardiovascular Events and Organ Damage in Carfilzomib-Dexamethasone versus Carfilzomib-Lenalidomide-Dexamethasone. A Real-Life Prospective Study |
| title_full_unstemmed | Carfilzomib-Based Regimen and Cardiotoxicity in Multiple Myeloma: Incidence of Cardiovascular Events and Organ Damage in Carfilzomib-Dexamethasone versus Carfilzomib-Lenalidomide-Dexamethasone. A Real-Life Prospective Study |
| title_short | Carfilzomib-Based Regimen and Cardiotoxicity in Multiple Myeloma: Incidence of Cardiovascular Events and Organ Damage in Carfilzomib-Dexamethasone versus Carfilzomib-Lenalidomide-Dexamethasone. A Real-Life Prospective Study |
| title_sort | carfilzomib based regimen and cardiotoxicity in multiple myeloma incidence of cardiovascular events and organ damage in carfilzomib dexamethasone versus carfilzomib lenalidomide dexamethasone a real life prospective study |
| topic | carfilzomib cardiotoxicity Kd KRd real-life dexamethasone |
| url | https://www.mdpi.com/2072-6694/15/3/955 |
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