Endocrine, metabolic, nutritional and body composition abnormalities are common in advanced intensively-treated (transplanted) multiple myeloma
| Autor: | D M, Greenfield, E, Boland, Y, Ezaydi, R J M, Ross, S H, Ahmedzai, J A, Snowden, Shehnaaz, Jivraj |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Infertility medicine.medical_specialty medicine.drug_class Cross-sectional study Nutritional Status Physiology Internal medicine medicine Vitamin D and neurology Humans Endocrine system Vitamin B12 Multiple myeloma Aged Transplantation business.industry Hematology Middle Aged medicine.disease Prolactin Cross-Sectional Studies Endocrinology Body Composition Corticosteroid Female Multiple Myeloma business |
| Zdroj: | Bone Marrow Transplantation. 49:907-912 |
| ISSN: | 1476-5365 0268-3369 |
| Popis: | Modern treatment strategies have increased life expectancy in multiple myeloma, but little is known about the endocrine, metabolic and nutritional status of long-term survivors. We performed endocrine, metabolic, bone, body composition and nutritional evaluations in 32 patients with intensively-treated, advanced but stable, myeloma a median duration of 6 years from diagnosis and three lines of intensive treatment, including at least one haematopoietic SCT procedure. All patients were off active treatment. There was a high prevalence of endocrine dysfunction: hypothyroidism (9%), hypogonadism (65% males) and elevated prolactin (19%). Adrenocortical function was preserved despite large cumulative corticosteroid pretreatment. Biochemical markers were consistent with postmenopausal status in all females and infertility in males. Nutritionally, 59% were vitamin D insufficient/deficient, reduced serum folate in 25% and vitamin B12 in 6%. Total body DEXA scanning confirmed 'sarcopenic-obesity' in 65%, but reduced bone density was seen in a minority. We conclude that potentially correctable endocrine, metabolic and nutritional abnormalities are prevalent in heavily-treated patients with stable multiple myeloma. Preservation of bone supports the efficacy of bisphosphonate treatment from diagnosis, but sarcopenic-obesity may contribute to frailty. Ultimately, multi-system screening and appropriate interventions may optimise quality of long-term survival and further studies are warranted. |
| Databáze: | OpenAIRE |
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