Recent Advances in Understanding the Mechanisms of Therapy-Related Cardiovascular Events in Pediatric Hematologic Malignancies

This narrative review synthesizes the most recent advances in elucidating the mechanisms underlying cardiovascular events associated with the treatment of pediatric hematologic malignancies. First, this review delineates the principal therapeutic modalities currently employed, including chemotherapy, radiotherapy, cellular immunotherapy, and small-molecule targeted therapy. Subsequently, this review offers a systematic and nuanced appraisal of the mechanisms through which these treatments precipitate cardiovascular injury, encompassing direct cardiotoxic effects, inflammatory activation, and immune-mediated tissue damage. Finally, this review examines emerging therapeutic targets with potential relevance for intervention, to refine treatment strategies, mitigate cardiovascular adverse effects, and enhance both quality of life and long-term outcomes in affected children. This review integrates these mechanisms within a cohesive, pediatric-specific conceptual framework and highlights actionable cardioprotective targets across therapeutic modalities.