FEATURES OF COMORBIDITY OF CHRONIC MYELOID LEUKEMIA WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE
https://doi.org/10.36604/1998-5029-2019-74-16-25
Abstract
Aim. To study the peculiarities of the comorbidity of chronic myeloid leukemia (CML) with chronic obstructive pulmonary disease (COPD). Materials and methods. 10 patients with CML and with concomitant disease COPD were examined; all had a history of long-term smoking; the smoking person index (SI) was 31.8±5.7 packs/year. CML therapy was carried out with the first generation tyrosine kinase inhibitor imatinib. In accordance with the classification of COPD severity (GOLD 2011), 6 patients of the II stage and 4 patients of the III stage were diagnosed in the main group. The control group included 20 people without hematological, bronchopulmonary and cardiological pathologies, non-smokers, by sex and age corresponding to CML patients. The second control group included 20 patients with COPD without concomitant hemoblastosis: 13 patients with stage II, 7 patients with stage III, all had a history of longterm smoking, SI was 31.9±5.0 pack/year. The third control group consisted of 20 patients with CML without concomitant bronchopulmonary pathology. Spirography, a study of the gas composition of the blood, X-ray, bronchoscopic examinations, a comprehensive ultrasound examination of the heart with determination of the parameters of pulmonary and central hemodynamics were performed for all those included in the study. In patients of the main and second control groups, a comparative study of the dynamics of stopping the main manifestations of exacerbation of COPD during treatment was conducted. Results. It was established that the course of COPD against the background of CML is aggravated and is characterized by the progression of pulmonary hypertension, impaired hemodynamics of the pulmonary circulation, systolic and diastolic dysfunction of the right ventricle. When full cytogenetic and large molecular responses of CML are achieved, the dynamics of the main clinical manifestations of COPD in CML does not differ from the dynamics of the corresponding symptoms in patients with COPD without hemoblastosis. The presence of a concomitant disease - COPD and its treatment does not significantly affect the course of CML and modern therapy with tyrosine kinase inhibitors. No effect of imatinib therapy on the development of exacerbations of COPD was noted. Conclusion. The combination of CML and COPD does not require any correction of the treatment of both diseases and their treatment for comorbidity can be carried out in full in accordance with the protocols.
About the Authors
V. V. Voytsekhovskiy
Amur State Medical Academy
Russian Federation
Russian Federation
MD, PhD, D.Sc. (Med.), Associate Professor, Head of Department of Hospital Therapy with Pharmacology Course
95 Gor'kogo Str., Blagoveshchensk, 675000, Russian Federation
T. V. Zabolotskikh
Amur State Medical Academy
Russian Federation
MD, PhD, D.Sc. (Med.), Professor, Rector
95 Gor'kogo Str., Blagoveshchensk, 675000, Russian Federation
Russian Federation
MD, PhD, D.Sc. (Med.), Professor, Rector
95 Gor'kogo Str., Blagoveshchensk, 675000, Russian Federation
E. A. Filatova
Amur Regional Clinical Hospital
Russian Federation
Russian Federation
MD, PhD (Med.), Hematologist
26 Voronkova Str., Blagoveshchensk, 675028, Russian Federation
A. A. Grigorenko
Amur Regional Oncological Dispensary
Russian Federation
Russian Federation
MD, PhD, D.Sc. (Med.), Professor, Head of Department of Morphology
110 Oktyabrʹskaya Str., Blagoveshchensk, 675000, Russian Federation
N. D. Goborov
Amur State Medical Academy
Russian Federation
MD, PhD (Med.), Assistant of Department of Hospital Therapy with Pharmacology Course
95 Gor'kogo Str., Blagoveshchensk, 675000, Russian Federation
Russian Federation
MD, PhD (Med.), Assistant of Department of Hospital Therapy with Pharmacology Course
95 Gor'kogo Str., Blagoveshchensk, 675000, Russian Federation
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For citations:
Voytsekhovskiy V.V., Zabolotskikh T.V., Filatova E.A., Grigorenko A.A., Goborov N.D. FEATURES OF COMORBIDITY OF CHRONIC MYELOID LEUKEMIA WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE. Bulletin Physiology and Pathology of Respiration. 2019;(74):16-25. (In Russ.) https://doi.org/10.36604/1998-5029-2019-74-16-25
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