Drug therapies used for the treatment of lymphoid malignancies and common cardiovascular toxicities
| Medication . | Use . | Select cardiovascular toxicities . |
|---|---|---|
| Acalabrutinib | CLL, NHL | Atrial fibrillation (≤5%), atrial flutter (≤5%), hypertension (3%) |
| Alemtuzumab | CLL | Hypotension (16%), cardiac arrhythmia (14%), hypertension (14%) |
| Azacitidine | NHL | Chest pain (16%), hypertension (9%), hypotension (7%), atrial fibrillation (<5%), cardiomyopathy (<5%) |
| Belinostat | NHL | Peripheral edema (20%), QTc prolongation (11%), hypotension (10%) |
| Bendamustine | NHL, HL, CLL | Peripheral edema (13%), tachycardia (7%), chest pain (6%), hypotension (6%), exacerbation of hypertension (3%) |
| Bleomycin | HL | Interstitial pneumonitis (acute or chronic: ≤5% to 10%), pulmonary, ischemic heart disease (<1%), Raynaud’s phenomenon (<1%), pulmonary fibrosis (≤5% to 10%) |
| Bortezomib | NHL | Hypotension (8% to 9%), cardiac disease (treatment emergent; 8%), acute pulmonary edema (≤1%), cardiac failure (≤1%), cardiogenic shock (≤1%), pulmonary edema (≤1%) |
| Brentuximab vedotin | HL | Peripheral edema (11%) |
| Carboplatin | HL, NHL | Arterial and venous thrombotic events, ischemic events, hypertension, hypotension |
| Carmustine | HSCT | Chest pain (5%), arterial occlusive disease, tachycardia |
| Cisplatin | HL, NHL | Arterial and venous thrombotic events, arrhythmias, hypertension, hypotension,vasospasm |
| Cladribine | HCL | (Peripheral) edema, phlebitis, tachycardia |
| Copanlisib | NHL | Hypertension (35%), hypertriglyceridemia (58%) |
| Cyclophosphamide | HL, NHL, CLL, HSCT | Arrhythmias, hemorrhagic myocarditis, pericarditis, pericardial effusion, even tamponade, myocardial infarction, arterial and venous thrombosis |
| Cytarabine (Ara-C) | HL, NHL, HSCT | Thrombophlebitis (common); angina pectoris, chest pain, pericarditis (rare) |
| Darutumumab | NHL | Hypertension (10%), infusion reaction |
| Daunorubicin Doxorubicin | Daunorubicin: NHL, ALL Doxorubicin: HL, NHL | Acute cardiotoxicity: ECG abnormalities including atrioventricular block, bradycardia, bundle branch block, extrasystoles (atrial or ventricular), nonspecific ST or T wave changes on ECG, sinus tachycardia, supraventricular tachycardia, tachyarrhythmia, ventricular tachycardia, decline in cardiac function, heart failure, cardiogenic shock, perimyocarditis Delayed cardiotoxicity: Heart failure, decline in cardiac function, arrhythmias |
| Dexamethasone | HL, NHL, ALL | Bradycardia, cardiac arrhythmia, cardiac failure, cardiomegaly, circulatory shock, edema, embolism (fat), hypertension, hypertrophic cardiomyopathy (premature infants), myocardial rupture (post-MI), syncope, tachycardia, thromboembolism, thrombophlebitis, vasculitis |
| Duvelisib | NHL, CLL | Edema (11% to 14%) |
| Etoposide | NHL, HL, HSCT | Hypotension (1% to 2%; due to rapid infusion) |
| Fludarabine | NHL, CLL | Peripheral edema (8%) |
| Ibrutinib | CLL, NHL | Peripheral edema (35%), hypertension (19%), atrial fibrillation/flutter (8%), ventricular tachycardia (<1%) |
| Idelalisib | CLL, NHL | Peripheral edema (10%) |
| Ifosfamide | HL, NHL | Arrhythmias, cardiac failure, cardiogenic shock, cardiomyopathy, myocardial infarction, myocarditis, pericardial effusion, pericarditis (risk of events especially with high dose therapy, fatal outcomes possible) |
| Lenalidomide | NHL, CLL | Peripheral edema (16% to 20%), hypotension (7%), hypertension (6%), chest pain (5%), palpitations (5%), deep vein thrombosis (2% to 4%), pulmonary embolism (1% to 2%) |
| Melphalan | HSCT | Peripheral edema (33%), vasculitis |
| Methotrexate | NHL | Pericarditis, pericardial effusion, hypotension, and thromboembolic events |
| Mitoxantrone | NHL | Arrhythmia (8%), ECG changes (3%), cardiomyopathy and heart failure |
| Mogamulizumab | NHL | Edema (16%), hypertension 10%), arrhythmia (5%) |
| Moxetumomab pasudotox | HCL | Capillary leak syndrome (34%) including hypotension, hypoalbuminemia, and hemoconcentration plus peripheral edema |
| Nivolumab | HL | Peripheral edema (10%), hypertension (7%), pulmonary embolism (rare), myocarditis (rare) |
| Ofatumumab | CLL, NHL | Peripheral edema (9%), hypertension/hypotension (5%), tachycardia (5%) |
| Oxaliplatin | HL | Edema (15%), prolonged QT interval and ventrical arrhythmias including torsades de pointes (rare) |
| Pegaspargase | ALL | Thromboembolic complications (8%), elevated triglycerides (30%) |
| Pentostatin | HCL, CLL, NHL | Chest pain, facial or peripheral edema, hypotension (3% to 10%) |
| Pembrolizumab | HL, NHL | Peripheral edema (15%), cardiac arrhythmia (11%), acute myocardial infarction (2%), cardiac tamponade (2%), facial edema (10%), ischemic heart disease (2%), pericardial effusion (2%), pericarditis (4%), pulmonary embolism (2%), myocarditis (rare) |
| Procarbazine | HL | Hypotension, syncope, tachycardia |
| Rituximab | NHL, CLL, HCL, ALL | Cardiac disorder (5% to 29%), flushing (5% to 14%), hypertension (6% to 12%), peripheral edema (8% to 16%); chest tightness (7%), hypotension (10%), significant cardiovascular event (2%) (acute myocardial infarction, cardiogenic shock, supraventricular cardiac arrhythmia, ventricular fibrillation, ventricular tachycardia) |
| Romidepsin | NHL | Hypotension (7% to 23%), ECG changes including QTc prolongation (1% to 2%) |
| Tazemetostat | NHL | Elevated triglycerides (36%) |
| Venetoclax | CLL | Edema (22%) |
| Vinblastine | HL | Hypertension (common); myocardial infarction, angina pectoris, transient abnormalities on ECG related to ischemia (rare) |
| Vincristine | HL, NHL, ALL | Hypertension, hypotension (presumed autonomic) |
| Zanubrutinib | NHL | Hypertension (12%), atrial fibrillation/flutter (2%) |
| Medication . | Use . | Select cardiovascular toxicities . |
|---|---|---|
| Acalabrutinib | CLL, NHL | Atrial fibrillation (≤5%), atrial flutter (≤5%), hypertension (3%) |
| Alemtuzumab | CLL | Hypotension (16%), cardiac arrhythmia (14%), hypertension (14%) |
| Azacitidine | NHL | Chest pain (16%), hypertension (9%), hypotension (7%), atrial fibrillation (<5%), cardiomyopathy (<5%) |
| Belinostat | NHL | Peripheral edema (20%), QTc prolongation (11%), hypotension (10%) |
| Bendamustine | NHL, HL, CLL | Peripheral edema (13%), tachycardia (7%), chest pain (6%), hypotension (6%), exacerbation of hypertension (3%) |
| Bleomycin | HL | Interstitial pneumonitis (acute or chronic: ≤5% to 10%), pulmonary, ischemic heart disease (<1%), Raynaud’s phenomenon (<1%), pulmonary fibrosis (≤5% to 10%) |
| Bortezomib | NHL | Hypotension (8% to 9%), cardiac disease (treatment emergent; 8%), acute pulmonary edema (≤1%), cardiac failure (≤1%), cardiogenic shock (≤1%), pulmonary edema (≤1%) |
| Brentuximab vedotin | HL | Peripheral edema (11%) |
| Carboplatin | HL, NHL | Arterial and venous thrombotic events, ischemic events, hypertension, hypotension |
| Carmustine | HSCT | Chest pain (5%), arterial occlusive disease, tachycardia |
| Cisplatin | HL, NHL | Arterial and venous thrombotic events, arrhythmias, hypertension, hypotension,vasospasm |
| Cladribine | HCL | (Peripheral) edema, phlebitis, tachycardia |
| Copanlisib | NHL | Hypertension (35%), hypertriglyceridemia (58%) |
| Cyclophosphamide | HL, NHL, CLL, HSCT | Arrhythmias, hemorrhagic myocarditis, pericarditis, pericardial effusion, even tamponade, myocardial infarction, arterial and venous thrombosis |
| Cytarabine (Ara-C) | HL, NHL, HSCT | Thrombophlebitis (common); angina pectoris, chest pain, pericarditis (rare) |
| Darutumumab | NHL | Hypertension (10%), infusion reaction |
| Daunorubicin Doxorubicin | Daunorubicin: NHL, ALL Doxorubicin: HL, NHL | Acute cardiotoxicity: ECG abnormalities including atrioventricular block, bradycardia, bundle branch block, extrasystoles (atrial or ventricular), nonspecific ST or T wave changes on ECG, sinus tachycardia, supraventricular tachycardia, tachyarrhythmia, ventricular tachycardia, decline in cardiac function, heart failure, cardiogenic shock, perimyocarditis Delayed cardiotoxicity: Heart failure, decline in cardiac function, arrhythmias |
| Dexamethasone | HL, NHL, ALL | Bradycardia, cardiac arrhythmia, cardiac failure, cardiomegaly, circulatory shock, edema, embolism (fat), hypertension, hypertrophic cardiomyopathy (premature infants), myocardial rupture (post-MI), syncope, tachycardia, thromboembolism, thrombophlebitis, vasculitis |
| Duvelisib | NHL, CLL | Edema (11% to 14%) |
| Etoposide | NHL, HL, HSCT | Hypotension (1% to 2%; due to rapid infusion) |
| Fludarabine | NHL, CLL | Peripheral edema (8%) |
| Ibrutinib | CLL, NHL | Peripheral edema (35%), hypertension (19%), atrial fibrillation/flutter (8%), ventricular tachycardia (<1%) |
| Idelalisib | CLL, NHL | Peripheral edema (10%) |
| Ifosfamide | HL, NHL | Arrhythmias, cardiac failure, cardiogenic shock, cardiomyopathy, myocardial infarction, myocarditis, pericardial effusion, pericarditis (risk of events especially with high dose therapy, fatal outcomes possible) |
| Lenalidomide | NHL, CLL | Peripheral edema (16% to 20%), hypotension (7%), hypertension (6%), chest pain (5%), palpitations (5%), deep vein thrombosis (2% to 4%), pulmonary embolism (1% to 2%) |
| Melphalan | HSCT | Peripheral edema (33%), vasculitis |
| Methotrexate | NHL | Pericarditis, pericardial effusion, hypotension, and thromboembolic events |
| Mitoxantrone | NHL | Arrhythmia (8%), ECG changes (3%), cardiomyopathy and heart failure |
| Mogamulizumab | NHL | Edema (16%), hypertension 10%), arrhythmia (5%) |
| Moxetumomab pasudotox | HCL | Capillary leak syndrome (34%) including hypotension, hypoalbuminemia, and hemoconcentration plus peripheral edema |
| Nivolumab | HL | Peripheral edema (10%), hypertension (7%), pulmonary embolism (rare), myocarditis (rare) |
| Ofatumumab | CLL, NHL | Peripheral edema (9%), hypertension/hypotension (5%), tachycardia (5%) |
| Oxaliplatin | HL | Edema (15%), prolonged QT interval and ventrical arrhythmias including torsades de pointes (rare) |
| Pegaspargase | ALL | Thromboembolic complications (8%), elevated triglycerides (30%) |
| Pentostatin | HCL, CLL, NHL | Chest pain, facial or peripheral edema, hypotension (3% to 10%) |
| Pembrolizumab | HL, NHL | Peripheral edema (15%), cardiac arrhythmia (11%), acute myocardial infarction (2%), cardiac tamponade (2%), facial edema (10%), ischemic heart disease (2%), pericardial effusion (2%), pericarditis (4%), pulmonary embolism (2%), myocarditis (rare) |
| Procarbazine | HL | Hypotension, syncope, tachycardia |
| Rituximab | NHL, CLL, HCL, ALL | Cardiac disorder (5% to 29%), flushing (5% to 14%), hypertension (6% to 12%), peripheral edema (8% to 16%); chest tightness (7%), hypotension (10%), significant cardiovascular event (2%) (acute myocardial infarction, cardiogenic shock, supraventricular cardiac arrhythmia, ventricular fibrillation, ventricular tachycardia) |
| Romidepsin | NHL | Hypotension (7% to 23%), ECG changes including QTc prolongation (1% to 2%) |
| Tazemetostat | NHL | Elevated triglycerides (36%) |
| Venetoclax | CLL | Edema (22%) |
| Vinblastine | HL | Hypertension (common); myocardial infarction, angina pectoris, transient abnormalities on ECG related to ischemia (rare) |
| Vincristine | HL, NHL, ALL | Hypertension, hypotension (presumed autonomic) |
| Zanubrutinib | NHL | Hypertension (12%), atrial fibrillation/flutter (2%) |
This table is not intended to be all inclusive. Percentages are listed when available and derived from package inserts available at www.dailymed.nlm.nih.gov. Rare adverse events are reported to the FDA through the Adverse Event Reporting System (AERS) and providers are encouraged to use this system for evaluation of more atypical presentations.
ALL, acute lymphoblastic leukemia.