Cardiotoxicity of Targeted Therapies in Hematologic Malignancies: From Molecular Mechanisms to Clinical Management

The therapeutic landscape of hematologic malignancies has been transformed over the past decade by the shift from conventional chemotherapy to targeted therapies, including proteasome, tyrosine kinase, and epigenetic regulators. Although these agents have significantly improved patient survival outcomes, this progress is tempered by the emergence of distinct cardiovascular toxicities that threaten both patient quality of life and long-term prognosis. Current clinical management is limited by the lack of standardized adverse event reporting mechanisms in trials and the operational complexity of existing risk stratification tools. In this context, a streamlined, personalized surveillance strategy is warranted. Comprehensive baseline cardiovascular assessment is paramount, with the frequency and modality of subsequent monitoring tailored specifically to the agent’s mechanism of action and the patient’s underlying risk profile. Crucially, when cardiotoxicity arises, the utilization of multidisciplinary cardio-oncology teams is indicated to manage the cardiac condition therapeutically, thereby avoiding the premature discontinuation of life-saving oncologic therapy. The ultimate goal remains maximizing the potent antitumor efficacy of these targeted therapies while rigorously protecting cardiovascular function.