FEATURES OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE ASSOCIATED WITH MULTIPLE MYELOMA
The aim of the research is to study the features of сhronic obstructive pulmonary disease (COPD) associated with multiple myeloma (MM). Among 123 patients with MM who have got treatment at the hematological department of the Amur Regional Clinical Hospital for the last 10 years COPD was diagnosed in 20 (16.3%) patients (study group). COPD is at the fifth place among comorbidities at MM. The group of comparison included 25 patients with COPD without hemoblastosis. Clinical, laboratory and functional study, endobronchial laser Doppler flowmetry were done to all the patients. It was found out that patients with COPD associated with MM have a significant reduction in endobronchial microcirculatory parameters, which can be caused both by the syndrome of increased blood viscosity and by violations of endobronchial microcirculation at bronchoobstructive process. COPD significantly limits the treatment policy in MM, since the operation of protocols which have severe hematological toxicity and include high doses of glucocorticoids can exacerbate inflammation in the bronchi and can lead to the development of pneumonia. At the same time, with the adequate treatment of exacerbations of COPD in patients with MM the dynamics of main clinical manifestations of bronchial process has no significant difference compared with the group of COPD patients without concomitant hemoblastosis.