ToolsCalculators
HFA-ICOS Baseline Cardio-Oncology Risk Assessment for Multiple Myeloma Therapies
Baseline cardiotoxicity risk stratification before proteasome-inhibitor or immunomodulatory-drug therapy for myeloma.
HFA-ICOS Baseline Cardio-Oncology Risk Assessment for Multiple Myeloma Therapies
Existing heart failure or cardiomyopathy
Prior proteasome-inhibitor cardiotoxicity
Venous thrombosis (DVT or PE)
Cardiac amyloidosis
Arterial vascular disease
Ischaemic heart disease, prior PCI/CABG, stable angina, TIA, stroke, or peripheral arterial disease.
Prior immunomodulatory-drug cardiovascular toxicity
Baseline LVEF <50%
Elevated baseline BNP or NT-proBNP
Age ≥75 years
Prior anthracycline exposure
Borderline LVEF 50-54%
Arrhythmia
Elevated baseline troponin
Hypertension
Age 65-74 years
Left ventricular hypertrophy
Diabetes mellitus
Hyperlipidaemia
Chronic kidney disease
Family history of thrombophilia
Prior radiotherapy to the thoracic spine
High-dose dexamethasone (>160 mg/month)
Current smoker or significant smoking history
Obesity (BMI >30 kg/m²)
ResultLow risk
No or only a single medium-risk (1-point) factor is present. Routine baseline assessment is sufficient.
- Medium-risk points
- 0
- Overall risk category
- Low risk
When to use
- Baseline cardiovascular risk stratification before starting proteasome-inhibitor/immunomodulatory-drug therapy in patients with cancer.
- Determining how intensively to monitor cardiac function during treatment.
Formula
Overall risk = Very high if any very-high-risk criterion is present; otherwise High if any high-risk criterion is present OR medium-risk points total ≥5; otherwise Moderate if medium-risk points total 2-4; otherwise Low (0 or 1 medium-risk point). Medium-risk items are weighted 1 or 2 points as specified.
Pearls and pitfalls
- Any single very-high-risk criterion overrides the point total and classifies the patient as very high risk.
- Risk category is intended to guide referral to cardio-oncology and the frequency of on-treatment cardiac imaging/biomarker surveillance, not to withhold effective cancer therapy.