Clinical and Immunological Features of Infectious Complications in Patients with Multiple Myeloma

Cover Page


Cite item

Full Text

Abstract

Background: Infectious complications — the leading cause of mortality in patients with multiple myeloma (MM), their appearance is regarded as an adverse prognostic factor in the course of the disease.

Objective: The aim of our study was to evaluate the clinical and immunological features of infectious complications in patients with G- immunochemical MM to find the most informative indicators in their forecasting.

Methods: A randomized controlled trial was made. All patients were divided into 3 groups for comparison: Group 1 (n =47) — MM patients, G-immunochemical variant with infection, Group 2 (n =54) — MM patients, G-immunochemical option no infectious complications, and Group 3 (n =125) — healthy volunteers. Research material was deoxygenated blood taken on admission of a patient to the hematology department before the pathogenetic treatment. Identification of G-variant was carried by immunofixation and electrophoresis. The immune status was assessed by indirect immunofluorescence. The concentration of IgA, M, E and G, and the levels of IL 2, IL 4, IL 8, TNF α, IFN γ in serum was determined by enzyme immunoassay. The activity of neutrophil granulocytes (NG) was studied by chemiluminescent analysis of spontaneous and induced production of reactive oxygen species. Statistical analysis was performed using the software STATISTICA v. 8.0 (USA).

Results: We analyzed data from 101 patients with MM and 125 healthy volunteers. The average age of MM patients was 60.53±6.78 years. The group of healthy volunteers was similar in sex and age to groups of patients with MM. In patients with MM in the presence of infectious complications the researchers detected combined secondary development of T and B cell immunodeficiency, changes in non-specific immunity depended on the stage of the disease, unidirectional irregularities in spontaneous and induced chemiluminescence activity NG in II stage disease and multidirectional irregularities in stage III (p =0.045). Prevalence of the content of proinflammatory cytokines on inflammatory (p <0.001) and the deviation of the immune response to Th1-type were detected.

Conclusion: the set of 6 informative indicators (the content of IL 4, IL 2, TNF α, IgG, the absolute number of CD4+ and CD19+ cells) enables the development of prediction method of infectious complications in patients with MM.

About the authors

O. V. Smirnova

Research Institute of Medical Problems of the North, Krasnoyarsk, Russian Federation

Author for correspondence.
Email: ovsmirnova71@mail.ru

доктор медицинских наук, заведующая лабораторией клинической патофизиологии НИИ медицинских проблем Севера Адрес: 660022, Красноярск, ул. Партизана Железняка, д. 3Г, тел.: +7 (391) 228-06-33

Россия

V. T. Manchuk

Research Institute of Medical Problems of the North, Krasnoyarsk, Russian Federation

Email: man417@rambler.ru

доктор медицинских наук, член-корреспондент РАН, профессор, научный
руководитель НИИ медицинских проблем Севера Адрес: 660022, Красноярск, ул. Партизана Железняка, д. 3Г, тел.: +7 (391) 228-06-33

Россия

Yu. N. Agilova

Research Institute of Medical Problems of the North, Krasnoyarsk, Russian Federation

Email: a_yulya@inbox.ru

младший научный сотрудник лаборатории клинической патофизиологии НИИ медицинских проблем Севера Адрес: 660022, Красноярск, ул. Партизана Железняка, д. 3Г, тел.: +7 (391) 228-06-33

Россия

References

  1. Votyakova O.M. Mnozhestvennaya mieloma. Klinicheskaya onkogematologiya. Pod red. M.A. Volkovoi [Multiple Myeloma. Clinical Oncohematology. Ed. by M.A. Volkova]. Moscow, 2007. P. 847–871.
  2. Bogdanov A.N., Mazurov V.I. Klinicheskaya gematologiya [Clinical Hematology]. St. Petersburg, Foliant, 2008. 484 p.
  3. Davydov M.I., Aksel' E.M. Statistics of malignant tumors in Russia and CIS countries. Vestnik RONTs im. N.N. Blokhina RAMN = Journal of N.N. Blokhin Russian Cancer Research Center RAMS. 2006;17(19 App.1):19–21.
  4. Bessmel'tsev S.S., Abdulkadyrov K.M. Mnozhestvennaya mieloma [Multiple Myeloma]. St. Petersburg, Dialekt, 2004. 446 p.
  5. Voitsekhovskii V.V., Landyshev Yu.S., Grigorenko A.A., Savinova T.A., Landyshev S.Yu., Goryacheva S.A., Mishuk V.P. Diagnosis and treatment of pneumonia in patients with multiple myeloma. Byulleten' fiziologii i patologii dykhaniya = Bulletin of the physiology and pathology of breathing. 2013;50:23–29.
  6. Golenkov A.K., Shabalin V.N. Mnozhestvennaya mieloma [Multiple Myeloma]. St. Petersburg, Gippokrat, 1995. 144 p.
  7. Kruglova Yu.D. Difficulties of diagnosis of multiple myeloma. Byulleten' meditsinskikh internet-konferentsii = Bulletin of medical internet conferences. 2013;3(30):764.
  8. Manchuk V.T., Smirnova O.V. Features prediction of occurrence of infectious complications after chemotherapy in patients with acute leukemia. Meditsinskaya immunologiya = Medical immunology. 2012;14(4–5):403–408.
  9. Smirnova O.V. Chronic myeloid leukemia: clinical and immunological features in adults. Byulleten' Vostochno-Sibirskogo nauchnogo tsentra SO RAMN = Bulletin of the East Siberian Scientific Center of the SD of the Russian academy of medical sciences. 2012;3–2:185–189.
  10. Smirnova O.V., Manchouk V.T., Savchenko A.A. Immune status & enzymes activity in blood lymphocytes in adult patients at different stages of acute lymphoblastic leukaemia. Indian J. Med. Res. 2011; 133 (3): 280–286.
  11. Faix J.D. Biomarkers of sepsis. Crit. Rev Clin Lab Sci. 2013; 50 (1): 23–36.
  12. Zemskov A.M., Karaulov A.V., Zemskov V.M. Kombinirovannaya immunokorrektsiya [Combination Immunotherapy]. Moscow, Nauka, 1994. 260 p.
  13. De Sole P., Lippa S., Lixxarru G. Whole blood chemiluminescence: a new technical approach to assess oxygen-dependent microbial activity of granulocytes. J. Clin. Lab. Autom. 1983; 3: 391–400.
  14. Durie B.G., Harousseau J.L., Miguel J.S., Blade J., Barlogie B., Anderson K. et al. International uniform response criteria for multiple myeloma. Leukemia. 2006; 20: 1467–1473.
  15. Kody MKB-10, elektronnaya versiya (Codes ICD-10, the electronic version). Available at: www.mkb10.ru (accessed: 26.10.2015).
  16. British Thoracic Scoiety Guidelines. Thorax. 2003; 58 (Suppl. II): 794.
  17. Kadagidze Z.R. Cytokines. Prakticheskaya onkologiya = Practical oncology. 2003;4(3):2–9.
  18. Ševčíková S., Kubiczková L., Sedlaříková L., Říhová L., Kryukov F., Szturz P., Hájek R. Cytokine profiles of multiple myeloma and Waldenström macroglobulinemia. Klin. Onkol. 2014; 27 (1): 18–23.
  19. Zheng M.M., Zhang Z., Belch A. R., Shively J.E., Pilarski L.M., Kirshner J. The systemic cytokine environment is permanently altered in multiple myeloma. PLoS One. 2013; 8 (3): 12–16.
  20. Ketlinskii S.A., Simbirtsev A.S. Tsitokiny [Cytokines]. Moscow, Foliant, 2008. 552 p.
  21. Rossi Zh.F. Interleukin-6 as a therapeutic target in oncology and immunopathology. Immunologiya gemopoeza = Hematopoiesis immunology. 2012;10(2):8–34.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2015 "Paediatrician" Publishers LLC



This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies