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Early Impact of Mobilization Process on Cardiac Function and Size in Patients Undergoing Autologous Hematopoietic Stem Cell Transplantation.

Background: The hematopoietic stem cell transplantation (HSCT) process is known to cause cardiac toxicity of different grades. In this paper, we aimed to evaluate the impact of mobilization procedure of hematopoietic stem cells for autologous HSCT process for left and right ventricle sizes and functions. Material and Methods: The data of 47 patients undergoing autologous HSCT were analyzed. All patients underwent hematopoietic stem cell mobilization with chemotherapy and filgrastim at 10 µg/kg/d. Echocardiography was performed two times: before enrolling in the transplantation process and afte

Cardiotoxicity of Non-Anthracycline Cancer Chemotherapy Agents.

Throughout the last decades, newly developed chemotherapeutic agents and immunotherapies that target signaling pathways have provided patients with better prognoses, improved their quality of life and increased survival rates, thus converting cancer to a stable chronic disease. However, non-anthracycline cancer chemotherapy agents and immunotherapies including human epidermal growth factor receptor 2 (HER2) inhibitors, vascular endothelial growth factor (VEGF) inhibitors, Bcr-Abl tyrosine-kinase inhibitors (TKI), proteasome inhibitors, immune checkpoint inhibitors and chimeric antigen receptor

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… Choose the best regimen and closely monitor for cardiotoxic manifestations Close collaboration between cardiologists and oncologists for choosing the best regimen Prefer agents with minimal cardiotoxic effects, at maximal tolerated dose Monitor for early signs of cardiotoxicity (recommended every 3 months …

Bidirectional Relationship Between Cancer and Heart Failure: Old and New Issues in Cardio-oncology.

The main focus of cardio-oncology has been the prevention and treatment of the cardiac toxicity of chemotherapy and radiotherapy. Furthermore, several targeted therapies have been associated with unexpected cardiotoxic side-effects. Recently, epidemiological studies reported a higher incidence of cancer in patients with heart failure (HF) compared with individuals without HF. On this basis, it has been proposed that HF might represent an oncogenic condition. This hypothesis is supported by preclinical studies demonstrating that hyperactivation of the sympathetic nervous system and renin-angiot

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… in oncological patients.[ 3 ] The co-occurrence of cancer and HF represents a major clinical problem, because each disease impinges on the treatment of the other disease, and consequently, has a detrimental impact on quality of life and survival.[ 4 , 5 ] In this scenario, the interaction between cardiologists …

Arterial stiffness in hematologic malignancies.

Malignant and cardiovascular disorders are the top causes of mortality worldwide. This article reviews the main literature data and mechanisms linking hematologic malignancies and arterial stiffness, focusing on recent experimental and clinical results. Several links were found in hematologic malignancies between complete blood count and arterial stiffness. Chemotherapy, especially anthracyclines, cyclophosphamide and tyrosine kinase inhibitors, as well as radiotherapy and hematopoietic stem cell transplantation are the main known causes of arterial stiffness increase in hematologic malignanci

High prevalence of cardiovascular and respiratory abnormalities in advanced, intensively treated (transplanted) myeloma: The case for 'late effects' screening and preventive strategies.

OBJECTIVES: Modern management of myeloma has significantly improved survival, with increasing numbers of patients living beyond a decade. However, little is known about the long-term cardiovascular and respiratory status of intensively treated and multiply relapsed survivors. METHODS: We performed detailed cardiovascular and respiratory evaluations in patients with intensively treated, advanced but stable myeloma. All patients had received at least two lines of treatment, including at least one haematopoietic stem cell transplantation procedure, but had stable, controlled disease and were off

Metastatic spinal tumor.

In accordance with extending survival periods of cancer patients, number of consecutively developing metastatic spinal tumor is also increasing. There have been improvements in the treatment results of metastatic spine tumor by virtue of the developments in diagnostic radiology, chemotherapy, adjuvant treatment, operative device and technique, discrete preoperative plan, and standardized operation. Accordingly, surgical indication has also increased. Clinically, in case of metastatic spine tumor, treatment of tumor itself should be focused on pain relief, preservation of neurologic function, p

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… Regarding metastatic spinal tumor in patients with neurologic deficit, having 3 months or more expected lifetime, a common view shared by most of the cardiologists is the performance of surgery. Despite, there is no consensus on this matter between spine surgeons and radiotherapists. …

Development and characterization of chimeric antigen receptor macrophages for amyloid clearance.

Systemic amyloidosis is a protein folding disorder characterized by the extracellular deposition of protein fibrils in tissues and vital organs, leading to dysfunction and mortality. While there are monoclonal antibody-based therapies that promote cell-mediated amyloid clearance in various stages of clinical development, there are currently no treatment options which focus on reducing the tissue amyloid burden. Therefore, the urgent need for a transformative approach to facilitate amyloid clearance and restore organ function remains paramount. We demonstrate that a short, polybasic peptide (p5

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… AL amyloidosis for cardiologists: awareness, diagnosis, and future prospects: JACC: CardioOncology state-of-the-art review . Cardio Oncol . ( 2022 ) 4 : 427–41 . 10.1016/j.jaccao.2022.08.009 PMC9700258 36444232 2 Buxbaum JN Eisenberg DS Fändrich M McPhail ED Merlini G Saraiva MJ . …

Drowning the kidneys: from fluid overload to physiology-guided fluid management in onco-hematology.

Acute kidney injury (AKI) is a frequent complication in patients with cancer. Although AKI in oncology is often multifactorial, it is frequently attributed to nephrotoxicity or intrinsic tubular injury. However, its hemodynamic mechanisms remain underrecognized. Accumulating evidence from critical care and cardiorenal medicine indicates that fluid overload, venous congestion, and increased intra-abdominal pressure are major drivers of kidney dysfunction and adverse outcomes in patients with cancer. These mechanisms are particularly relevant in onco-hematology, where protocol-driven hydration,

Adverse Cardiac Effects of CAR T-Cell Therapy: Characteristics, Surveillance, Management, and Future Research Directions.

This review summarizes the current literature on the adverse cardiac effects of CAR T-cell therapy. Case reports and series suggest that major adverse cardiovascular events are not uncommon after CAR T-cell therapy; however, limited data exist regarding incidence, pathophysiology, and prevention strategies related to CAR T-associated cardiovascular events. As cellular therapy advances and the indications for its use continue to expand, it is essential to better understand its associated cardiovascular toxicities. Biomarkers, cardiac imaging, longitudinal data from larger populations, and trans

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… arrhythmias, congestive heart failure, and cardiac arrest are overall rare (<0.5%). 32 While the exact rates of MACE either with CAR T-cells or BiTEs may vary, studies across multiple large centers, trials, and registries show that cardiovascular adverse events are not uncommon and it is important for both cardiologists …

Increased risk of cardio-cerebrovascular disease after hematopoietic cell transplantation in patients with previous history.

BackgroundThe impacts of previous cardio-cerebrovascular disease (pre-CCVD) on the outcomes of hematopoietic cell transplantation (HCT) are not well described. Patients with pre-CCVD may often be poor candidates for HCT. This study aimed to investigate the impact of pre-CCVD on transplant outcomes.MethodsA retrospective study was conducted between patients with and without pre-CCVD who consecutively received allogeneic or autologous HCT between November 2013 and January 2020 with a matching of age and disease status. The cardiovascular complications and HCT outcomes of the two groups were eval

Взгляды пациентов и группы по уходу за почками на лечащую нагрузку и способность пожилых людей с хроническими заболеваниями почек: качественное исследование.

ЦЕЛЬ: Хроническая болезнь почек (КХД) часто является множественным заболеванием, а прогрессирование к более серьезным заболеваниям, как правило, связано с увеличением потребностей в управлении, включая изменение образа жизни, увеличение количества медикаментов и расширение участия клинических работников. В ходе этого исследования были изучены взгляды группы по уходу за пациентами и почками на характер и масштабы этой рабочей нагрузки (нагрузка на лечение), а также факторы, способствующие укреплению способности (способности управлять здоровьем) пожилых людей, имеющих ККД. DESIGN: Качественное п

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… A limitation was the lack of input from primary care clinicians, as well as other specialties (eg, endocrinologists, cardiologists) with a key role in CKD care, which may have resulted in additional themes. …

Cardiovascular adverse effects of immunotherapy in cancer: insights and implications.

Immunotherapy has revolutionized cancer treatment, offering novel therapeutic strategies such as immune checkpoint inhibitors (ICIs), chimeric antigen receptor (CAR) T-cell therapy, and cancer vaccines. However, these modalities are associated with varying cardiovascular toxicities that may affect treatment continuation and patient outcomes. Cardiovascular complications from ICIs, such as myocarditis (incidence 0.04-1.14%, mortality 25-50%), arrhythmias, heart failure, and thromboembolic events, are primarily mediated by autoreactive T-cell activation and immune-related inflammation. CTLA-4 an

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… These systems will assist oncologists and cardiologists in dynamically adjusting therapy based on an individual’s evolving risk profile, ensuring a balance between maximizing therapeutic efficacy and minimizing adverse effects. …

The Italian Society of Andrology and Sexual Medicine (SIAMS), along with ten other Italian Scientific Societies, guidelines on the diagnosis and management of erectile dysfunction.

PURPOSE: Erectile dysfunction (ED) is one of the most prevalent male sexual dysfunctions. ED has been in the past mistakenly considered a purely psycho-sexological symptom by patients and doctors. However, an ever-growing body of evidence supporting the role of several organic factors in the pathophysiological mechanisms underlying ED has been recognized. METHODS: The Italian Society of Andrology and Sexual Medicine (SIAMS) commissioned an expert task force involving several other National Societies to provide an updated guideline on the diagnosis and management of ED. Derived recommendations

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… Internal Medicine (Società Italiana di Medicina Interna, SIMI), The Italian Society of Obesity (Società Italiana dell’Obesità, SIO), The Italian Society of Metabolism, Diabetes and Obesity (Società Italiana Metabolismo, Diabete, Obesità, SIMDO), the Italian National Association of Hospital Clinical Cardiologists … It is to be noted that American cardiologists openly consider e-Cig and HnB devices as tools to reduce the CV risk in patients refractory to the fundamental, healthy choice to definitively quit smoking [ 229 ]. Robust evidence is needed to advise the same in ED patients. …

The Role of Frailty in Cardio-oncology and its Challenges.

Frailty has received increasing scientific attention as a potential explanation for adverse health outcomes among older adults. In cardio-oncology, frailty is particularly relevant due to the dual burden of cardiovascular disease and cancer, both of which accelerate the general decline in health associated with ageing. Therefore, understanding and addressing frailty in cardio-oncology has paramount importance for optimising patient outcomes, personalising treatment plans, and improving quality of life. In this review, we aim to discuss: the pathophysiology of frailty in the context of cardio-o

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… Cardiovascular disease (CVD) and cancer are among the leading causes of mortality, particularly in older populations. 1 Cardio-oncology is a dynamic and interdisciplinary field that brings together a diverse team of specialists, including oncologists, cardiologists, and other dedicated healthcare providers …

Unveiling the shared etiology between gastrointestinal disorders and valvular heart diseases through a genome-wide pleiotropy study.

This study explores the genetic link between gastrointestinal disorders and valvular heart disease (VHD), aiming to clarify shared mechanisms through a genome-wide pleiotropy analysis. We assessed the genetic correlation between six gastrointestinal disorders-including GERD, IBS, PUD, IBD, Crohn's disease, and ulcerative colitis-and VHD, employing methods like linkage disequilibrium score regression and pleiotropic analysis under a composite null hypothesis. Our results show significant genetic correlations, particularly with GERD (rg = 0.211), IBS (rg = 0.23), and PUD (rg = 0.21). Fifteen var

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… Integrating these insights into clinical practice encourages a multidisciplinary approach, wherein cardiologists and gastroenterologists collaborate to monitor and manage patients with comorbid conditions. …

Assessment and Management of Cardiotoxicity in Hematologic Malignancies.

With the increasing overall survival of cancer patients due to recent discoveries in oncology, the incidence of side effects is also rising, and along with secondary malignancies, cardiotoxicity is one of the most concerning side effects, affecting the quality of life of cancer survivors. There are two types of cardiotoxicity associated with chemotherapy; the first one is acute, life-threatening but, fortunately, in most of the cases, reversible; and the second one is with late onset and mostly irreversible. The most studied drugs associated with cardiotoxicity are anthracyclines, but many new

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… A joint effort of oncologists and cardiologists is needed to elaborate guidelines for diagnosis and management of chemotherapy-related cardiotoxicity. Data Availability The data supporting this systematic review are from previously reported studies and datasets, which have been cited. …

Integration of Chronic Oncology Services in Noncommunicable Disease Clinic in Rural Rwanda.

BackgroundIn rural sub-Saharan Africa, access to care for severe non-communicable diseases (NCDs) is limited due to myriad delivery challenges. We describe the implementation, patient characteristics, and retention rate of an integrated NCD clinic inclusive of cancer services at a district hospital in rural Rwanda.MethodsIn 2006, the Rwandan Ministry of Health at Rwinkwavu District Hospital (RDH) and Partners In Health established an integrated NCD clinic focused on nurse-led care of severe NCDs, within a single delivery platform. Implementation modifications were made in 2011 to include cance

Typical aspects in the rehabilitation of cancer patients suffering from metastatic bone disease or multiple myeloma.

BackgroundThe aim of this study was to present a practical concept focusing on typical aspects of regular physical activity, exercise and physical modalities for patients suffering from metastatic bone disease or multiple myeloma.MethodsA narrative review of the relevant scientific literature and presentation of clinical experiences.ResultsIn cancer patients with metastatic bone disease or multiple myeloma, pain is treated in an interdisciplinary and multimodal setting by using medication, radiotherapy and physical medical modalities (e.g. transcutaneous electrical nerve stimulation); however,

The emerging role of echocardiography-based techniques in cardio-onco-hematology.

In decades, the overall survival rate for cancer patients has improved significantly with continuous advances in cancer treatment technologies. However, cancer therapeutics-related cardiac dysfunction (CTRCD) has been one of the most worrying side effects, particularly in patients with hematological malignancies (HM), affecting the quality of life for cancer survivors. Early detection and prompt treatment are of vital importance. Echocardiography-based techniques can even identify subclinical myocardial damages, which is crucial for preventing irreversible myocardial damage. Conventional trans

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… A united effort by oncologists and cardiologists is needed to develop guidelines for the diagnosis and management of chemotherapy-related cardiotoxicity. …

Geriatric Assessment in Patients Aged 70 Years and Older Considered for CAR T-Cell Therapy: A Retrospective Study.

Background/Objectives: Population aging has increased the incidence of non-Hodgkin lymphoma in older adults, who often receive suboptimal treatment. Geriatric assessment is a key tool to evaluate frailty and guide therapeutic decisions. CAR T-cell therapy is effective but associated with significant toxicities, including cytokine release syndrome (CRS) and immune effector cell-associated neurotoxicity syndrome (ICANS), which may be more severe in older patients. This study evaluated the role of geriatric assessments in patients aged 70 years and older referred for CAR T-cell therapy, focusing

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… Geriatric assessment-guided multidisciplinary clinics (GA-MDC), involving close collaboration between hematologists, geriatricians, cardiologists, physical therapists and nutritionists, have emerged as a promising model of care [ 10 ]. …