| Author/Editor | Zver, Samo | |
| Title | Kardiotoksičnost velikih odmerkov ciklofosfamida in melfalana pri zdravljenju bolnikov z diseminiranim plazmocitomom | |
| Type | monografija | |
| Place | Ljubljana | |
| Publisher | Medicinska fakulteta | |
| Publication year | 2007 | |
| Volume | str. 83 | |
| Language | slo | |
| Abstract | Background. Multiple myeloma (MM) is an incurable malignant neoplastic disease derived from lymphatic B-cells. Recently, tandem autologous hemopoetic stem cell transplantation (HSCT) was recognised as the most effective treatment modality in patients with MM. During the six months treatment period patients are treated with high doses of cyclophosphamide followed twice with high doses of melphalan. With this treatment we influence the quality of life and simultaneously prolong the patient's survival. But there are very scant data, if any, regarding potential cardiotoxic side effects of this treatment modality. Therefore, in prospective clinical study we decided to evaluate cardiotoxicity with biochemical parameters troponin I (TnI), brain natriuretic peptide (BNP) and endothelin-1 (ET-1), together with echocardiography. Methods. We included 30 patients with newly diagnosed multiple myeloma. They all had absent clinical signs for heart disease. After they were treated with three cycles of VAD chemotherapy (vincristine, epirubicine, dexamethasone), they received high doses of cyclophosphamide 4 mg/m2 (cycle CY) as part of stem cell collection regimen. This was followed by two autologous tandem HSCT, where patients received melphalan 200 mg/mz (cycle MEL I and cycle MEL II). During the fifteen-day treatment period with cyclophosphamide and melphalan, blood was routinely controlled for biochemical parameters (TnI, BNP, ET-1) at six time points, the first time before the start of the chemotherapy and thereafter on the first, fourth, eighth, eleventh and fifteenth day of chemotherapy. Dynamic patterns were followed linearly, i.e. within each chemotherapy cycle and also vertically, comparing equal time points between all three cycles of chemotherapy. Results of all four echocardiography measurements were also compared in a linear pattern. (Abstract truncated at 2000 characters) | |
| Descriptors | MULTIPLE MYELOMA HEMATOPOIETIC STEM CELL TRANSPLANTATION MELPHALAN CYCLOPHOSPHAMIDE TROPONIN I NATRIURETIC HORMONE ENDOTHELIN-1 ECHOCARDIOGRAPHY VENTRICULAR DYSFUNCTION, RIGHT MITRAL VALVE INSUFFICIENCY |