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Abstract
Introduction: Global survival rates for multiple myeloma (MM) have increased with the advent of proteasome inhibitors (PI). However, adverse cardiovascular events (ACE) of different degrees of severity
resulting from the use of PI have been reported. Objective: to evaluate the incidence of ACE in MM patients treated with PI at a single center between 2007 and 2017, and to analyze the possible association
between exposure to carfilzomib and occurrence of ACE. Materials and methods: multiple myeloma
patients, not eligible for Auto-SCT, treated with PI at the Hospital Español of Buenos Aires between 2007
and 2017 were included in the study. Age, staging, cardiovascular history/risk factors (CH), and treatment regimens were recorded. Association between carfilzomib exposure and occurrence of ACE, and
between occurrence of ACE in carfilzomib-exposed patients and CH was analyzed. Results: the study
sample comprised 23 patients (average age: 71±6.9 years) with ISS stage I (n=5), II (n=3) and III (n=15).
Smoking and arterial hypertension were the most frequent CH. All patients received bortezomib, and
4 also received carfilzomib; 5 patients had an ACE. Fisher's exact test showed no significant association between occurrence of ACE and exposure to carfilzomib (p=0.19), nor between occurrence of ACE in carfilzomib-exposed patients and CH (p=0.17). Conclusion: the benefits of PI therapy strongly outweigh the cardiovascular damage they may potentially cause. Standardized protocols to identify patients at risk, close cooperation between hematologists and oncologists and further clinical research in order to improve detection and prevention strategies are necessary to minimize ACE.
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