CARDIOTOXICITY OF CYCLOPHOSPHAMIDE: CURRENT STATE OF THE PROBLEM

ASHOT AVAGIMYAN; LEV KAKTURSKY

doi:10.52340/jecm.2022.03.14

CARDIOTOXICITY OF CYCLOPHOSPHAMIDE: CURRENT STATE OF THE PROBLEM

Authors

ASHOT AVAGIMYAN
LEV KAKTURSKY

DOI:

https://doi.org/10.52340/jecm.2022.03.14

Keywords:

cyclophosphamide, cardiotoxicity, immunosuppression

Abstract

Cyclophosphamide is an alkylating anticancer drug, oxazaphosphorine-substituted nitrogen mustard, with pronounced cytotoxic and immunosuppressive potential. This drug is the basis of most immunosuppressive mode widely used for organ transplantation and chemotherapeutical treatment of the wide spectrum of malignant neoplasms of various localizations, particularly breast cancer, Hodgkin's disease, non-Hodgkin's lymphoma, leukemia, and others. Moreover, based on the V.A. Nasonova Institute of Rheumatology guidelines and the protocols of EULAR and ACR, cyclophosphamide is also used to treat inflammatory arthritis (rheumatoid-, lupus-, sclerodermic-, sarcoid- etc.), as well as for vasculitis. Moreover, cyclophosphamide-based pulse therapy is usually used in the cases of acute autoimmune processes with high activity index. Such a broad spectrum of cyclophosphamide prescription has become the explanation for the growing cases of cardiotoxicity consequence among cyclophosphamide-administered patients. This review article aims to assess and analyze the available data on the cyclophosphamide-driven disturbances of cardiovascular homeostasis.

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References

Halyabar O, Friedman KG, Sundel RP, et al. Cyclophosphamide use in treatment of refractory Kawasaki disease with coronary artery aneurysms. Pediatr Rheumatol Online J. 2021;19(1):31-45. doi: 10.1186/s12969-021-00526-0.

Gómez-Figueroa E, Gutierrez-Lanz E, Alvarado-Bolaños A, et al. Cyclophosphamide treatment in active multiple sclerosis. Neurol Sci. 2021;42(9):3775-3780. doi: 10.1007/s10072-021-05052-1.

Helsby N, Yong M, Burns K, et al. Cyclophosphamide bioactivation pharmacogenetics in breast cancer patients. Cancer Chemother Pharmacol. 2021;88(3):533-542. doi: 10.1007/s00280-021-04307-0.

Avagimyan A.A., Mkrtchyan L.H., Gevorkyan A.A., et al. Relationship between Chemotherapy and Atrial Fibrillation: Clinical Case. Rational Pharmacotherapy in Cardiology. 2021;17(5):785-791. doi: 10.20996/1819-6446-2021-10-17

Avagimyan A.A., Mkrtchyan L.G., Kononchuk N.B., et al. Chemotherapy as a possible trigger for the myocardial lipomatosis development. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2021;27(6):706-712. doi: 10.18705/1607-419X-2021-27-6-706-712.

Avagimyan A, Kakturskiy L, Heshmat-Ghahdarijani K, et al. Anthracycline Associated Disturbances of Cardiovascular Homeostasis. Current Problem in Cardiology. 2021 May 29;100909. doi:10.1016/j.cpcar- diol.2021.100909.

Avagimyan A, Kakturskiy L. The impact of trimetazidine on the anthropometric parameters of doxorubicin-cyclophosphamide mode of chemotherapy–induced heart alteration. Georgian Medical News. 2022;№1(322):145-148

Avagimyan A, Mrochek A, Sarrafzadegan N, et al. Mitochondrial dysfunction associated with AC mode of chemotherapy intake. European Heart Journal. 2020;41suppl.2:ehaa946.3293. DOI:10.1093/ehjci/ehaa946.3293.

Čelutkienė J, Pudil R, López-Fernández T, et al. Role of cardiovascular imaging in cancer patients receiving cardiotoxic therapies: a position statement on behalf of the Heart Failure Association (HFA), the European Association of Cardiovascular Imaging (EACVI) and the Cardio-Oncology Council of the European Society of Cardiology (ESC). Eur J Heart Fail. 2020;22(9):1504-24. DOI:10.1002/ejhf.1957.

Zamorano JL, Lancellotti P, Rodriguez Muñoz D, et al.ESC Scientific Document Group. 2016 ESC Position Paper on cancer treatments and cardiovascular toxicity developed under the auspices of the ESC Committee for Practice Guidelines: The Task Force for cancer treatments and cardiovascular toxicity of the European Society of Cardiology (ESC). Eur Heart J. 2016;37(36):2768-801. DOI:10.1093/eu- rheartj/ehw211.

Curigliano G, Lenihan D, Fradley M, et al. ESMO Guidelines Committee. Management of cardiac disease in cancer patients throughout oncological treatment: ESMO consensus recommendations. Ann Oncol. 2020;31(2):171-90. DOI:10.1016/j.annonc.2019.10.023.

Ezekowitz JA, O'Meara E, McDonald MA, et al. 2017 Comprehensive Update of the Canadian Cardiovascular Society Guidelines for the Management of Heart Failure. Can J Cardiol. 2017;33(11):1342-433. DOI:10.1016/j.cjca.2017.08.022.

Armenian SH, Lacchetti C, Barac A, et al. Prevention and Monitoring of Cardiac Dysfunction in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline. J Clin Oncol. 2017;35(8):893-911. DOI:10.1200/JCO.2016.70.5400.

Gilchrist SC, Barac A, Ades PA, et al. American Heart Association Exercise, Cardiac Rehabilitation, and Secondary Prevention Committee of the Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; and Council on Peripheral Vascular Disease. Cardio-Oncology Rehabilitation to Manage Cardiovascular Outcomes in Cancer Patients and Survivors: A Scientific Statement From the American Heart Association. Circulation. 2019;139(21):997-1012. DOI:10.1161/CIR. 0000000000000679.