Applied cardio-oncology in hematological malignancies refers to the integration of cardiovascular care and management for patients with blood cancer, particularly leukemia, lymphoma, and multiple myeloma. Hematological cancer therapy-related cardiotoxicity deals with the most common cardiovascular complications of conventional chemotherapy, targeted therapy, immunotherapy, chimeric antigen receptor T (CAR-T) cell and tumor-infiltrating lymphocyte therapies, bispecific antibodies, and hematopoietic stem cell transplantation. This narrative review focuses on hematological cancer-therapy-related cardiotoxicity’s definition, risk stratification, multimodality imaging, and use of cardiac biomarkers to detect clinical and/or subclinical myocardial dysfunction and electrical instability. Moreover, the most common cardiotoxic profiles of the main drugs and/or therapeutic interventions in patients with hematological malignancies are described thoroughly.

Combined therapeutic regimens, including molecular targeted agents, are considered standard treatment for advanced gastric and gastroesophageal junction cancer. We present an extremely rare case of acute reversible cardiac dysfunction in a 20-year-old patient after administration of trastuzumab plus 5-fluorouracil for the treatment of metastatic gastroesophageal junction cancer. During the first day of chemotherapy, the patient complained of retrosternal pain radiating to the scapular regions bilaterally. Infusion was immediately stopped, and signs of myocardial ischemia were depicted on the electrocardiogram (ECG) with a positive high-sensitivity troponin T assay, confirming the diagnosis of acute coronary syndrome. Echocardiography revealed global left ventricular hypokinesia and severe systolic dysfunction. After appropriate treatment, the patient recovered, and three days later, he had preserved left ventricular function. Coronary angiography ruled out coronary artery disease. The reported case of acute and severe reversible cardiac dysfunction due to a specific combination regimen in a patient with low pre-treatment risk of cancer therapy-related cardiovascular toxicity (CTR-CVT) highlights the gaps in evidence regarding the risk assessment tools for Heart Failure Association-International Cardio-Oncology Society (HFA-ICOS), representing an atypical variant of takotsubo cardiomyopathy. This case underscores the importance of developing personalized surveillance protocols during therapeutic interventions to mitigate potential adverse effects.

Objective: Early diagnosis and treatment of metastatic pericardial disease are crucial to prevent the life-threatening complication of cardiac tamponade. Thin Layer Cytology (TLC), a widely adopted technique in cytology, has gained significant acceptance for most specimens. Our study aimed to assess the utility of TLC in diagnosing metastatic neoplasms and their origins in pericardial effusions, as well as monitoring response to chemotherapy. Methods: We examined 184 pericardial fluids collected by pericardiocentesis and processed using the ThinPrep liquid-based technique. Various immunocytochemical markers were used to determine the site of metastatic neoplasms. We also evaluated the response to therapy in 53 patients with lung and breast cancer. Results: Out of 184 specimens, 113 pericardial fluids were diagnosed as positive for malignancy, while 71 were negative. Twenty-three cases of unknown primary site were included in the total positive cases. Ninety cases positive for malignancy had a known primary site of origin, including 31 lung carcinomas, 22 breast carcinomas, 10 ovarian carcinomas, 6 T-cell lymphomas, 3 urinary bladder carcinomas, 4 renal carcinomas, 5 adenocarcinomas of the colon, 5 prostate carcinomas, 2 parotid adenocarcinomas, and 2 melanomas. Regarding the 53 cases with chemotherapy treatment, the cytologic examination of pericardial fluid showed a remarkable reduction in neoplastic burden after the third dose of cisplatin or thiotepa instilled into the pericardial cavity. ThinPrep provided excellent preservation of cytomorphological features, high cellularity per slide, and a clear background. This comprehensive analysis provides crucial information about the types and distribution of cancerous cells present in the samples. Conclusions: Thin Layer Cytology (TLC) is a valuable diagnostic tool for detecting metastatic pericardial malignancy. It allows the examination of exfoliated cells from the pericardial fluid, providing crucial information for diagnosis, management, and monitoring the acute responsiveness to intrapericardial chemotherapy. Immunocytochemistry (IHC) can identify specific markers for various types of cancer, enabling a more accurate diagnosis and guiding further treatment decisions.

Acquired hemophilia A (AHA) is a rare bleeding disorder characterized by spontaneous bleeding in individuals with no previous personal or family history of bleeding, caused by the development of autoantibodies against coagulation Factor VIII (FVIII). These autoantibodies may be associated with drugs, autoimmune disorders, malignancies, and pregnancy. Pregnancy‐associated AHA (PA‐AHA) is a very rare condition, accounting for approximately 1%–5% of all AHA cases. Emicizumab, a bispecific FVIII‐mimetic monoclonal antibody, was originally approved for Congenital Hemophilia A (with or without FVIII inhibitors) and has since gained widespread recognition and clinical utility in the management of AHA as well. We report a case of PA‐AHA that was successfully managed with emicizumab. A 46‐year‐old woman was admitted with vaginal bleeding and extensive ecchymoses. The patient’s obstetric history was notable for a twin gestation achieved through in vitro fertilization (IVF) using donor oocytes. The patient reported recurrent ecchymoses and menorrhagia beginning in the postpartum period. Laboratory examination revealed severe anemia with normal platelet counts and prothrombin time (PT), but a markedly prolonged activated partial thromboplastin time (aPTT) of 94.5 s. Immunological and virology testing, as well as cancer biomarkers, were negative. Initially, the patient received bypassing hemostatic therapy with recombinant activated Factor VII (rFVIIa), along with intensive immunosuppressive therapy (IST) consisting of corticosteroids, rituximab, and cyclophosphamide, in accordance with current international recommendations. However, no clinical response was observed. Treatment with emicizumab was subsequently initiated according to the proposed dosing schedule. Within 2 days, all bleeding manifestations resolved rapidly. Notably, FVIII activity, measured using a chromogenic assay, remained markedly reduced. After 566 days of follow‐up, FVIII activity spontaneously normalized, allowing discontinuation of emicizumab. No further bleeding episodes were observed. Although emicizumab is increasingly incorporated into the management of AHA, clinical experience in PA‐AHA remains limited. The present case adds to the existing literature by supporting the safety and efficacy of emicizumab in PA‐AHA, highlighting its role as an effective hemostatic bridge to remission in complex clinical settings.