LONG TERM FOLLOW-UP REPORT OF CARDIAC TOXICITY IN PATIENTS WITH MULTIPLE MYELOMA TREATED WITH TANDEM AUTOLOGOUS HEMATOPOETIC STEM CELL TRANSPLANTATION

  • Mirta Kozelj Dept. of Cardiology University Centre Ljubljana
  • Samo Zver Department of Haematology, University Medical Centre Ljubljana, Zaloska 7, 1525 Ljubljana, Slovenija
  • Vesna Zadnik Institute of Oncology, Zaloska 2, 1525 Ljubljana, Slovenija

Abstract

Background. Tandem autologous hematopoetic stem cell transplantation (ta-HSCT) is a standard treatment for multiple myeloma (MM). Patients receive high-dose cyclophosphamide (CY), followed by two myeloablative cycles of melphalan (MEL). There are scarce data about long term cardiotoxicity.

Patients and methods. We studied 12 patients (62.25 ± 8.55 years) six years after completion of MM treatment with ta-HCST. Late cardiotoxic effects were evaluated clinically and echocardiographically.

Results. None of the patients developed clinical signs of heart failure, all were in sinus rhythm and NT-pro BNP concentration was elevated (778 ± 902.76 pg/mL). The left ventricular (LV) size remained normal. The LV ejection fraction did not decrease (73.75 ± 5.67%, 69.27 ± 6.13%, p = NS). The LV diastolic function parameters (E, A, ratio E/A and A/a) did not change significantly. In tissue Doppler parameters we observed a nonsignificant decrease in Em (10.26 ± 2.63 cm/s, 7.57 ± 1.43 cm/s) and Sm velocities (8.7 ± 0.87 cm/s, 7.14 ± 1.17 cm/s, p = NS). The E/Em values were in an abnormal range (8.66 ± 1.05, 10.55 ± 2.03).

Conclusion. The treatment of MM with ta-HSCT, during which patients receive high dose CY followed by two myeloablative cycles of MEL, causes mild, chronic, partially reversible and clinically silent cardiotoxic side-effects. However, ta-HSCT in patients with MM is a safe regarding cardiotoxic side effects, but because of increasing life expectancy needs long term attention.

Author Biographies

Mirta Kozelj, Dept. of Cardiology University Centre Ljubljana
Samo Zver, Department of Haematology, University Medical Centre Ljubljana, Zaloska 7, 1525 Ljubljana, Slovenija
Vesna Zadnik, Institute of Oncology, Zaloska 2, 1525 Ljubljana, Slovenija
Published
2013-05-22
How to Cite
Kozelj, M., Zver, S., & Zadnik, V. (2013). LONG TERM FOLLOW-UP REPORT OF CARDIAC TOXICITY IN PATIENTS WITH MULTIPLE MYELOMA TREATED WITH TANDEM AUTOLOGOUS HEMATOPOETIC STEM CELL TRANSPLANTATION. Radiology and Oncology, 47(2). Retrieved from https://www.radioloncol.com/index.php/ro/article/view/1470
Section
Clinical oncology