Cardiac and renal complications of carfilzomib in patients with multiple myeloma.
Τίτλος | Cardiac and renal complications of carfilzomib in patients with multiple myeloma. |
Publication Type | Journal Article |
Year of Publication | 2017 |
Authors | Dimopoulos, M. A., Roussou M., Gavriatopoulou M., Psimenou E., Ziogas D., Eleutherakis-Papaiakovou E., Fotiou D., Migkou M., Kanellias N., Panagiotidis I., Ntalianis A., Papadopoulou E., Stamatelopoulos K., Manios E., Pamboukas C., Kontogiannis S., Terpos E., & Kastritis E. |
Journal | Blood Adv |
Volume | 1 |
Issue | 7 |
Pagination | 449-454 |
Date Published | 2017 Feb 28 |
ISSN | 2473-9529 |
Abstract | Clinical trials with carfilzomib have indicated a low but reproducible incidence of cardiovascular and renal toxicities. Among 60 consecutive myeloma patients treated with carfilzomib-based regimens who were thoroughly evaluated for cardiovascular risk factors, 12% (95% confidence interval, 3.8%-20%) experienced a reversible reduction of left ventricular ejection fraction (LVEF) by ≥20%, an objective measure of cardiac dysfunction. The incidence of LVEF reduction was 5% at 3 months, 8% at 6 months, 10% at 12 months, and 12% at 15 months, whereas the respective carfilzomib discontinuation rate unrelated to toxicity was 17%, 35%, 41%, and 49%. The presence of any previously known cardiovascular disease was associated with an increased incidence of cardiac events (23.5% vs 7%; = .07), but there was no association with the dose of carfilzomib or the duration of infusion. Re-treatment with carfilzomib at lower doses was possible. Carfilzomib was commonly associated with a transient reduction of estimated glomerular filtration rate (eGFR) but also improved renal function in 55% of patients with baseline eGFR <60 mL/min/1.73 m. Further investigation is needed to elucidate the underlying mechanisms of carfilzomib-related cardiorenal toxicity. |
DOI | 10.1182/bloodadvances.2016003269 |
Alternate Journal | Blood Adv |
PubMed ID | 29296960 |
PubMed Central ID | PMC5738981 |