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  • Echocardiographic assessment of the cardiac toxicity of high dose cyclophosphamide and melphalan = Ehokardiografska ocena toksičnosti visokih odmerov ciklofosfamida in melfalana
    Koželj, Mirta ...
    8ackground. Tandem autologous hematopoetic stem cell transplantation (HSC) hasbeen recognized as an effective treatment modality in patients with multiple myeloma. During the treatment period, ... patients received high-dose cyclophosphamide followed by two myeloablative dosages of melphalan. There arevery scarce data about potential treatment-related cardiotoxic side effects. Methods. The study included 30 patients with multiple myeloma who were treated with three cycles of chemotherapy followed by high-dose cyclophosphamide (cycle C`n and two autologous tandem HSCT treatments with melphalan (cycle MEL I and cycle MEL II). All patients underwent conventional and tissue Doppler echocardiographic examinations prior to cyclophosphamide therapy (Echo 0), before the MEL I cycle (Echo 1), before the MEL II cycle (Echo 2) and three months after the completion of therapy (Echo 3). Results. Concerning the parameters of left ventricular diastolic function, the durationof a wave in the Doppler pulmonary vein flow signal increased significantly compared with its basal value (Echo 0/Echo 1: p=0.008, Echo 0/Echo 3; p=0.026). There was also a significant decrease in the A/a ratio of flow velocities during chemotherapy (Echo 0/Echo 1: p=0.002, Echo 0/Echo 3: p<0.0001). Early diastolic tissue Doppler velocities (Em) decreased significantly during individual cycles of chemotherapy (p=0.006). A significant post-treatment increase in the incidence of mitral regurgitation was observed (Echo 0/Echo 3; p=0.003). Pericardial effusion occurred in six patients (20.6 %). Conclusions. Treatment of multiple myeloma patients with tandem autologous HSCT is cardiotoxic. Doppler echocardiography studies revealed worsening of left ventricular diastolic function and occurrence of functional mitral regurgitation.
    Source: Slovenska pediatrija : revija Združenja pediatrov Slovenije in Združenja specialistov šolske in visokošolske medicine Slovenije. - ISSN 1318-4423 (Letn. 5, št. 1, 2008, str. 22-27)
    Type of material - article, component part
    Publish date - 2008
    Language - english
    COBISS.SI-ID - 24471001

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