Cardio-oncology and Oncohematology: Examination Algorithms, Prophylactic and Treatment of Cardiotoxicity, Trends in Rehabilitation

Elena Ivanovna Emelina, G.E. Gendlin, I.G. Nikitin,

DOI:

https://doi.org/10.21320/2500-2139-2021-14-2-239-261

Successful chemotherapy in the treatment of hematological diseases is determined not only by the efficacy of antitumor drugs, but by the timely correction of adverse events, among which especially important are cardiac complications associated with both already existing cardiovascular diseases and cardiotoxicity of cytostatic drugs. Of particular importance is also a frequent lack of systemic cardiological examination of oncohematological patients. The urgency of this issue was the reason for creating cardio-oncological clinics focused on the closest co-operation of cardiologists with drug chemotherapy experts. Hematological patients are a particular group among chemotherapy recipients. Potential curability of an oncohematological disease and achieving durable MRD-negative remission raise the importance of irreversible or long-term cardiac complications directly affecting the quality of life and life expectancy. Besides, in some cases long-term or life-long administration of certain cardiotoxic antitumor drugs requires a particular cardiological follow-up. A broad variety of cardiotoxic effects of antitumor drugs and peculiarities of their clinical manifestations call for the exact algorithms of cardiological examination to be observed for the timely detection and treatment of cardiovascular complications. The now available studies and interdisciplinary work of cardiologists and oncologists (oncohematologists) can yield such algorithms for examination and the approaches to prophylactic and treatment of cardiotoxicity as well as to rehabilitation of patients.

  • Elena Ivanovna Emelina NI Pirogov Russian National Research Medical University, 1 Ostrovityanova str., Moscow, Russian Federation, 117997 ; ФГАОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава России, ул. Островитянова, д. 1, Москва, Российская Федерация, 117997
  • G.E. Gendlin NI Pirogov Russian National Research Medical University, 1 Ostrovityanova str., Moscow, Russian Federation, 117997 ; ФГАОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава России, ул. Островитянова, д. 1, Москва, Российская Федерация, 117997
  • I.G. Nikitin NI Pirogov Russian National Research Medical University, 1 Ostrovityanova str., Moscow, Russian Federation, 117997 ; ФГАОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава России, ул. Островитянова, д. 1, Москва, Российская Федерация, 117997
  1. Zamorano JL, Lancellotti P, Munoz DR, et al. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines. Eur Heart J. 2016;37(36):2768–801. doi: 10.1093/eurheartj/ehw211. DOI: https://doi.org/10.1093/eurheartj/ehw211
  2. Lyon AR, Dent S, Stanway S, et al. Baseline cardiovascular risk assessment in cancer patients scheduled to receive cardiotoxic cancer therapies: a position statement and new risk assessment tools from the Cardio-Oncology Study Group of the Heart Failure Association of the European Society of Cardiology in collaboration with the International Cardio-Oncology Society. Eur J Heart Fail. 2020;22(11):1945–60. doi: 10.1002/ejhf.1920. DOI: https://doi.org/10.1002/ejhf.1920
  3. Curigliano G, Lenihan D, Fradley M, et al. Management of cardiac disease in cancer patients throughout oncological treatment: ESMO consensus recommendations. ESMO Guidelines Committee. Ann Oncol. 2020;31(2):171–90. doi: 10.1016/j.annonc.2019.10.023. DOI: https://doi.org/10.1016/j.annonc.2019.10.023
  4. S. Department of Health and Human Services, National Institutes of Health, National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE). Version 5.0, 2017. Available from: https://ctep.cancer.gov/protocolDevelopment/electronic_applications/docs/CTCAE_v5_Quick_Reference_8.5×11.pdf (accessed 10.02.2021).
  5. Кулиева А.А., Емелина Е.И., Гендлин Г.Е. и др. Сердечно-сосудистые осложнения терапии ингибиторами контрольных точек иммунитета. Качественная клиническая практика. 2019;4:55–65. doi: 10.1016/2588-0519-2019-4-55-65.
  6. [Kulieva AA, Emelina EI, Gendlin GE, et al. Cardiovascular complications of immune checkpoint inhibitors. Kachestvennaya klinicheskaya praktika. 2019;4:55–65. doi: 10.1016/2588-0519-2019-4-55-65. (In Russ)]
  7. Kim P, Zarifa A, Salih M, et al. Cardiotoxicity of FDA-approved immune checkpoint inhibitors: A rare but serious adverse event. J Immunother Precis Oncol. 2018;1(2):68–77. doi: 4103/JIPO.JIPO_15_18. DOI: https://doi.org/10.4103/JIPO.JIPO_15_18
  8. Postow MA, Sidlow R, Hellmann MD. Immune-Related Adverse Events Associated with Immune Checkpoint Blockade. N Engl J Med. 2018;378(2):158–68. doi: 10.1056/NEJMra1703481. DOI: https://doi.org/10.1056/NEJMra1703481
  9. Шубникова Е.В., Букатина Т.М., Вельц Н.Ю. и др. Ингибиторы контрольных точек иммунного ответа: новые риски нового класса противоопухолевых средств. Безопасность и риск фармакотерапии. 2020;8(1):9–22. doi: 10.30895/2312-7821-2020-8-1-9-22.
  10. [Shubnikova EV, Bukatina TM, Velts NYu, et al. Immune Response Checkpoint Inhibitors: New Risks of a New Class of Antitumor Agents. Safety and Risk of Pharmacotherapy. 2020;8(1):9–22. doi: 10.30895/2312-7821-2020-8-1-9-22. (In Russ)] DOI: https://doi.org/10.30895/2312-7821-2020-8-1-9-22
  11. Armand P. Immune checkpoint blockade in hematologic malignancies. Blood. 2015;125(22):3393–400. doi: 10.1182/blood-2015-02-567453. DOI: https://doi.org/10.1182/blood-2015-02-567453
  12. Лепик К.В. Ингибиторы иммунных контрольных точек в терапии лимфом. Клиническая онкогематология. 2018;11(4):303–12. doi: 10.21320/2500-2139-2018-11-4-303-312.
  13. [Lepik KV. Immune Checkpoint Inhibitors in the Treatment of Lymphomas. Clinical oncohematology. 2018;11(4):303–12. doi: 10.21320/2500-2139-2018-11-4-303-312. (In Russ)] DOI: https://doi.org/10.21320/2500-2139-2018-11-4-303-312
  14. Cardinale D, Colombo A, Sandri MT, et al. Prevention of High-Dose Chemotherapy-Induced Cardiotoxicity in High-Risk Patients by Angiotensin-Converting Enzyme Inhibition. Circulation. 2006;114(23):2474–81. doi: 10.1161/CIRCULATIONAHA.106.635144. DOI: https://doi.org/10.1161/CIRCULATIONAHA.106.635144
  15. Gilchrist SC, Barac A, Ades PA, et al. Cardio-oncology rehabilitation to manage cardiovascular outcomes in cancer patients and survivors: a scientific statement from the American Heart Association. 2019;139(21):997–1012. doi: 10.1161/CIR.0000000000000679. DOI: https://doi.org/10.1161/CIR.0000000000000679
  16. Larsen CM, Mulvagh SL. Cardio-oncology: what you need to know now for clinical practice and echocardiography. Echo Res Pract. 2017;4(1):R33–R41. doi: 10.1530/ERP-17-0013. DOI: https://doi.org/10.1530/ERP-17-0013
  17. Maia TN, Araujo GB, Teixeira JA, et al. Cardiotoxicity of Doxorubicin Treatment and Physical Activity: A Systematic Review. Int J Cardiovasc Sci. 2017;30(1):70–80. doi: 10.5935/2359-4802.20170004. DOI: https://doi.org/10.5935/2359-4802.20170004
  18. Fischetti F, Greco G, Cataldi S, et al. Effects of Physical Exercise Intervention on Psychological and Physical Fitness in Lymphoma Patients. 2019;55(7):379. doi: 10.3390/medicina55070379. DOI: https://doi.org/10.3390/medicina55070379
  19. Lenneman AJ, Wang L, Wigger M, et al. Heart transplant survival outcomes for adriamycin-dilated cardiomyopathy. Am J Cardiol. 2013;111(4):609–12. doi: 10.1016/j.amjcard.2012.10.048. DOI: https://doi.org/10.1016/j.amjcard.2012.10.048

Keywords:

oncohematology, cardio-oncology, cardiotoxicity, antitumor drugs, prophylactic of cardiac adverse events, cardio-oncological rehabilitation

Downloads

Download data is not yet available.

Author Biography

  • Elena Ivanovna Emelina, NI Pirogov Russian National Research Medical University, 1 Ostrovityanova str., Moscow, Russian Federation, 117997, ФГАОУ ВО «РНИМУ им. Н.И. Пирогова» Минздрава России, ул. Островитянова, д. 1, Москва, Российская Федерация, 117997

    MD, PhD

Published

01.04.2021

Issue

COMPLICATIONS OF ONCOHEMATOLOGICAL DISEASES

How to Cite

Emelina E.I., Gendlin G.E., Nikitin I.G. Cardio-oncology and Oncohematology: Examination Algorithms, Prophylactic and Treatment of Cardiotoxicity, Trends in Rehabilitation. Clinical Oncohematology. Basic Research and Clinical Practice. 2021;14(2):239–261. doi:10.21320/2500-2139-2021-14-2-239-261.

Most read articles by the same author(s)