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Ahmed AS, Gassas RS, Ahmed ME, Osman G, Alsaeed AS, Absi AN, Alamoudi SM, Alahmadi MD, Khalil MM, ElDadah SK, Hemaidi IY, Rajkhan WA. The Role of Pre-bone Marrow Transplantation Pulmonary Function Test in Predicting Post-transplant Noninfectious Pulmonary Complications. SAUDI JOURNAL OF MEDICINE & MEDICAL SCIENCES 2023; 11:339-344. [PMID: 37970453 PMCID: PMC10634462 DOI: 10.4103/sjmms.sjmms_65_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 06/08/2023] [Accepted: 08/09/2023] [Indexed: 11/17/2023]
Abstract
Background Pulmonary function test (PFT) is used as a tool for pre-transplant risk assessment and as a predictor of post-transplant outcomes. As there are currently few studies that discuss the role of PFT in bone marrow transplantation (BMT) patients in Saudi settings, and as the number of transplant patients with benign and malignant conditions continues to increase, this study was conducted with the aim of assessing the local practice. Methods This retrospective cohort study included all adult patients who underwent BMT at Princess Noorah Oncology Center, King Abdulaziz Medical City, Jeddah, between 2014 and 2020. The association between established patient-related risk factors and the incidence of pulmonary complications among autologous and allogeneic groups was assessed. Results A total of 186 patients were included (autologous = 143; allogenic = 43), of which 115 (61.8%) were male. At the pre-BMT phase, about 30% of the patients had comorbidities and 51% had received two rounds of salvage chemotherapy, while 16.1% had received radiation therapy. In the autologous group, the only PFT parameter that was a significant predictor of post-BMT pulmonary complications was forced vital capacity <80% (P = 0.012), while in the allogenic group, no parameter was significantly associated with pulmonary complications. The patient-related factors that were associated with respiratory distress in the autologous group were lung involvement (P = 0.03) and pre-transplant radiation (P = 0.044). Conclusion The findings of this study indicated that forced vital capacity <80% was a significant factor in predicting non-infectious complications in the autologous group. Furthermore, lung involvement and pre-transplant radiation were the patient-related factors associated with pulmonary complications.
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Affiliation(s)
- Amani S. Ahmed
- Department of Adult Hematology/Bone Marrow Transplant Section, King Abdulaziz Medical City, Ministry of National Guard–Health Affairs, Jeddah, Saudi Arabia
| | - Roaa S. Gassas
- Department of Adult Hematology/Bone Marrow Transplant Section, King Abdulaziz Medical City, Ministry of National Guard–Health Affairs, Jeddah, Saudi Arabia
| | - Mohamed E. Ahmed
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
- Department of Basic Sciences, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Ghaya Osman
- Department of Adult Hematology/Bone Marrow Transplant Section, King Abdulaziz Medical City, Ministry of National Guard–Health Affairs, Jeddah, Saudi Arabia
| | - Ahmed S. Alsaeed
- Department of Adult Hematology/Bone Marrow Transplant Section, King Abdulaziz Medical City, Ministry of National Guard–Health Affairs, Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Ahmed N. Absi
- Department of Adult Hematology/Bone Marrow Transplant Section, King Abdulaziz Medical City, Ministry of National Guard–Health Affairs, Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Sameer M. Alamoudi
- Department of Adult Hematology/Bone Marrow Transplant Section, King Abdulaziz Medical City, Ministry of National Guard–Health Affairs, Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Majed D. Alahmadi
- Department of Adult Hematology/Bone Marrow Transplant Section, King Abdulaziz Medical City, Ministry of National Guard–Health Affairs, Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Manar M. Khalil
- Department of Adult Hematology/Bone Marrow Transplant Section, King Abdulaziz Medical City, Ministry of National Guard–Health Affairs, Jeddah, Saudi Arabia
| | - Saleem K. ElDadah
- Department of Adult Hematology/Bone Marrow Transplant Section, King Abdulaziz Medical City, Ministry of National Guard–Health Affairs, Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Ihab Y. Hemaidi
- Department of Adult Hematology/Bone Marrow Transplant Section, King Abdulaziz Medical City, Ministry of National Guard–Health Affairs, Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Walaa A. Rajkhan
- Department of Adult Hematology/Bone Marrow Transplant Section, King Abdulaziz Medical City, Ministry of National Guard–Health Affairs, Jeddah, Saudi Arabia
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
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Morfino P, Aimo A, Castiglione V, Chianca M, Vergaro G, Cipolla CM, Fedele A, Emdin M, Fabiani I, Cardinale D. Cardiovascular toxicity from therapies for light chain amyloidosis. Front Cardiovasc Med 2023; 10:1212983. [PMID: 37476571 PMCID: PMC10354454 DOI: 10.3389/fcvm.2023.1212983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/23/2023] [Indexed: 07/22/2023] Open
Abstract
Amyloid light-chain (AL) amyloidosis is a hematological disorder characterized by abnormal proliferation of a plasma cell clone producing monoclonal free light chains that misfold and aggregate into insoluble fibrils in various tissues. Cardiac involvement is a common feature leading to restrictive cardiomyopathy and poor prognosis. Current first-line treatments aim at achieving hematological response by targeting the plasma cell clones, and these have been adapted from multiple myeloma therapy. Patients with AL amyloidosis often exhibit multiorgan involvement, making them susceptible to cancer therapy-related cardiovascular toxicity. Managing AL amyloidosis is a complex issue that requires enhanced knowledge of the cardio-oncological implications of hematological treatments. Future research should focus on implementing and validating primary and secondary prevention strategies and understanding the biochemical basis of oncological therapy-related damage to mitigate cardiovascular toxicity.
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Affiliation(s)
- Paolo Morfino
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Alberto Aimo
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Vincenzo Castiglione
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Michela Chianca
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
| | - Giuseppe Vergaro
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Carlo Maria Cipolla
- Cardioncology Unit, Cardioncology and Second Opinion Division, European Institute of Oncology, I.R.C.C.S., Milan, Italy
| | - Antonella Fedele
- Cardioncology Unit, Cardioncology and Second Opinion Division, European Institute of Oncology, I.R.C.C.S., Milan, Italy
| | - Michele Emdin
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Iacopo Fabiani
- Interdisciplinary Center for Health Sciences, Scuola Superiore Sant’Anna, Pisa, Italy
- Cardiology Division, Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Daniela Cardinale
- Cardioncology Unit, Cardioncology and Second Opinion Division, European Institute of Oncology, I.R.C.C.S., Milan, Italy
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Wechalekar AD, Cibeira MT, Gibbs SD, Jaccard A, Kumar S, Merlini G, Palladini G, Sanchorawala V, Schönland S, Venner C, Boccadoro M, Kastritis E. Guidelines for non-transplant chemotherapy for treatment of systemic AL amyloidosis: EHA-ISA working group. Amyloid 2023; 30:3-17. [PMID: 35838162 DOI: 10.1080/13506129.2022.2093635] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
BACKGROUND This guideline has been developed jointly by the European Society of Haematology and International Society of Amyloidosis recommending non-transplant chemotherapy treatment for patients with AL amyloidosis. METHODS A review of literature and grading of evidence as well as expert recommendations by the ESH and ISA guideline committees. RESULTS AND CONCLUSIONS The recommendations of this committee suggest that treatment follows the clinical presentation which determines treatment tolerance tempered by potential side effects to select and modify use of drugs in AL amyloidosis. All patients with AL amyloidosis should be considered for clinical trials where available. Daratumumab-VCD is recommended from most untreated patients (VCD or VMDex if daratumumab is unavailable). At relapse, the two guiding principles are the depth and duration of initial response, use of a class of agents not previously exposed as well as the limitation imposed by patients' fitness/frailty and end organ damage. Targeted agents like venetoclax need urgent prospective evaluation. Future prospective trials should include advanced stage patients to allow for evidence-based treatment decisions. Therapies targeting amyloid fibrils or those reducing the proteotoxicity of amyloidogenic light chains/oligomers are urgently needed.
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Affiliation(s)
- Ashutosh D Wechalekar
- National Amyloidosis Centre, University College London (Royal Free Campus), London, UK
| | - M Teresa Cibeira
- Amyloidosis and Myeloma Unit, Hospital Clinic of Barcelona, IDIBAPS, Barcelona, Spain
| | - Simon D Gibbs
- Victorian and Tasmanian Amyloidosis Service, Eastern Health Monash University Clinical School, Box Hill, VIC, Australia
| | - Arnaud Jaccard
- Hematology Department, French Reference Center for AL Amyloidosis (Limoges-Poitiers), CHU Limoges, Limoges, France
| | - Shaji Kumar
- Division of Hematology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Giampaolo Merlini
- Amyloidosis Research and Treatment Center, Foundation "Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo" and Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Giovanni Palladini
- Amyloidosis Research and Treatment Center, Foundation "Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Policlinico San Matteo" and Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Vaishali Sanchorawala
- Amyloidosis Center, Boston University School of Medicine and Boston Medical Center, Boston, MA, USA
| | - Stefan Schönland
- Medical Department V, Amyloidosis Center, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Mario Boccadoro
- Department of Molecular Biotechnology and Health Sciences, University of Turin, Turin, Italy
| | - Efstathios Kastritis
- Department of Clinical Therapeutics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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Celik Z, Boşnak Güçlü M, Özkurt ZN. Exercise capacity, physical activity and quality of life in patients with newly diagnosed hematologic malignancies: a cross-sectional study. Physiother Theory Pract 2022; 39:1152-1162. [DOI: 10.1080/09593985.2022.2035865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Zeliha Celik
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Meral Boşnak Güçlü
- Department of Physiotherapy and Rehabilitation, Faculty of Health Sciences, Gazi University, Ankara, Turkey
| | - Zübeyde Nur Özkurt
- Department of Hematology, Faculty of Medicine, Gazi University, Ankara, Turkey
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Backs D, Saglam I, Löffler C, Ihne S, Morbach C, Brenner S, Angermann C, Ertl G, Frantz S, Störk S, Knop S, Güder G. Prevalence of cardiovascular risk factors and diseases in patients with multiple myeloma undergoing autologous peripheral blood stem cell transplantation. Oncotarget 2019; 10:3154-3165. [PMID: 31139330 PMCID: PMC6516713 DOI: 10.18632/oncotarget.26872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 04/03/2019] [Indexed: 11/30/2022] Open
Abstract
Multiple myeloma (MM) is the second most common hematologic malignancy and occurs similar to cardiovascular diseases (CVD), in the sixth/seventh decade. The aim of this retrospective cohort study was to evaluate the prevalence and prognostic value of cardiovascular risk factors (CVRF) and CVD in 325 patients with MM undergoing autologous peripheral blood stem cell transplantation (PBSCT) at the University Hospital of Würzburg between 03/2004 and 12/2011. Mean age in the total cohort was 61 years. Among CVRF, prevalence of arterial hypertension was highest (59.7%), followed by overweight (54.2%) and positive smoking history (18.2%). The prevalence of heart failure (3.1%) or coronary heart disease (4.8%) was low. During a median follow-up of 36 months, 18% of the patients died. Hypertension (HR = 1.83, p = 0.048) as well as positive smoking history (HR = 2.13, p = 0.02) were independently associated with increased mortality risk in multivariate analysis. In a subgroup analysis of 100 patients echocardiographic parameters were compared before and after PBSCT. Echocardiography revealed a significant reduction of left atrial diameters (–1.5 mm, p = 0.009) and septum thickness (–1.0 mm, p = 0.001), non-significant reduction of systolic function, and an increase of the prevalence of diastolic dysfunction (+14%; p = 0.01). In this study CVRF, especially hypertension and smoking, are strong predictors of poor survival in patients with MM undergoing autologous PBSCT. Echocardiography before and after treatment shows subtle changes in systolic function but an increase of the prevalence of diastolic dysfunction.
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Affiliation(s)
- Deborah Backs
- Comprehensive Heart Failure Center Würzburg, University of Würzburg, Würzburg, Germany.,Department of Internal Medicine I, Division of Cardiology, University Hospital of Würzburg, Würzburg, Germany.,Department of Medicine II, Division of Cardiology, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Ilknur Saglam
- Comprehensive Heart Failure Center Würzburg, University of Würzburg, Würzburg, Germany.,Department of Internal Medicine I, Division of Cardiology, University Hospital of Würzburg, Würzburg, Germany
| | - Claudia Löffler
- Department of Internal Medicine II, Division of Hematology, University Hospital of Würzburg, Würzburg, Germany
| | - Sandra Ihne
- Department of Internal Medicine II, Division of Hematology, University Hospital of Würzburg, Würzburg, Germany
| | - Caroline Morbach
- Comprehensive Heart Failure Center Würzburg, University of Würzburg, Würzburg, Germany.,Department of Internal Medicine I, Division of Cardiology, University Hospital of Würzburg, Würzburg, Germany
| | - Susanne Brenner
- Comprehensive Heart Failure Center Würzburg, University of Würzburg, Würzburg, Germany.,Department of Internal Medicine I, Division of Cardiology, University Hospital of Würzburg, Würzburg, Germany
| | - Christiane Angermann
- Comprehensive Heart Failure Center Würzburg, University of Würzburg, Würzburg, Germany
| | - Georg Ertl
- Comprehensive Heart Failure Center Würzburg, University of Würzburg, Würzburg, Germany
| | - Stefan Frantz
- Comprehensive Heart Failure Center Würzburg, University of Würzburg, Würzburg, Germany.,Department of Internal Medicine I, Division of Cardiology, University Hospital of Würzburg, Würzburg, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center Würzburg, University of Würzburg, Würzburg, Germany.,Department of Internal Medicine I, Division of Cardiology, University Hospital of Würzburg, Würzburg, Germany
| | - Stefan Knop
- Department of Internal Medicine II, Division of Hematology, University Hospital of Würzburg, Würzburg, Germany
| | - Gülmisal Güder
- Comprehensive Heart Failure Center Würzburg, University of Würzburg, Würzburg, Germany.,Department of Internal Medicine I, Division of Cardiology, University Hospital of Würzburg, Würzburg, Germany
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6
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Scarlata S, Annibali O, Santangelo S, Tomarchio V, Ferraro S, Armiento D, Scardocci A, Arcese W, Antonelli Incalzi R, Avvisati G. Pulmonary complications and survival after autologous stem cell transplantation: predictive role of pulmonary function and pneumotoxic medications. Eur Respir J 2017; 49:49/3/1601902. [DOI: 10.1183/13993003.01902-2016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Accepted: 12/15/2016] [Indexed: 01/15/2023]
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7
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Santalla Martínez M, Blanco Cid N, Dacal Quintas R. Bortezomib-induced lung toxicity. Arch Bronconeumol 2014; 50:564-5. [PMID: 24445175 DOI: 10.1016/j.arbres.2013.11.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 11/25/2013] [Accepted: 11/27/2013] [Indexed: 11/17/2022]
Affiliation(s)
| | - Nagore Blanco Cid
- Servicio de Neumología, Complexo Hospitalario de Ourense, Ourense, España
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