IMPACT OF CHEMOTHERAPY ON PROOXIDANT-ANTIOXIDANT STATUS IN PATIENTS WITH MULTIPLE MYELOMA AND CONCOMITANT CORONARY ARTERY DISEASE

Abstract

Introduction. Multiple myeloma, an oncopathology that remains challenging to treat, is characterized by a 54% 5-year survival rate despite advancements in modern treatment strategies. Numerous studies have substantiated the correlation between high prooxidant concentrations and the progression of multiple myeloma. This progression is often associated with alterations in antioxidant defense mechanisms. Patients with coronary artery disease also experience changes in their antioxidant defense that may enhance the deleterious effects of active oxygen species and elevate the risk of chemotherapy-related organotoxic effects.
 The aim of this study is to investigate the specificities of the prooxidant-antioxidant status in patients with multiple myeloma and concomitant coronary artery disease during chemotherapy.
 Materials and methods. 42 patients with multiple myeloma were examined, 22 (52,5%) of them had concomitant coronary artery disease. According to the coronary artery disease, patients with multiple myeloma were divided into two groups. All patients obtain standard chemotherapy schemes. Assessment of the patients was performed four times: before and after the 1st and 5th chemotherapy course. TBA-reactants and catalase activity were measured in blood serum.
 Results. Both in I and II group of patients, TBA-reactants concentration in blood serum was increased in 1.85 (р1<0,0001) and in 2.35 (р1<0,0001) times respectively compare to healthy people before chemotherapy. Although in the patients with concomitant coronary artery disease TBA-reactants concentration in blood serum was increased in 1,28 (р2<0,0001) times compare to I group of patients. Simultaneously in II group of patients catalase activity was decreased in 1.28 (р4 <0,0001) times compare to healthy people and in 1,37 (р5 <0,0001) times compare to I group patients. Before the second course of chemotherapy in II group of patients, TBA-reactants level was increased in 1.03 (р<0.05) times compared to the first examination and in 1.27 (р<0.05) times compared to I group. In II group of patients, catalase activity was decreased in 1.24 (р<0.05) times compared to the first examination and in 1.38 (р<0.001) times compared to the II group. In II group of patients level of TBA-reactants was decreased in 1,13 (p<0,01) times compare to the first examination, but it was in 1,17(р<0,05) higher than TBA-reactants level in I group. Simultaneously catalase activity was decreased in 1.4 (р<0.05) times compare to the first examination.
 Conclusions. The progression of multiple myeloma is marked by the development of a prooxidant-antioxidant imbalance. In both the I and II patient groups, the level of TBA-reactants increased significantly by 1.85 (p<0.0001) and 2.35 (p<0.0001) times, respectively, compared to the reference value. The presence of concomitant coronary artery disease in multiple myeloma patients led to a 1.28-fold elevation in TBA-reactants levels (p<0.0001) compared to those without cardiovascular diseases. Simultaneously, catalase activity decreased by 1.37 times (p<0.0001) compared to patients without cardiovascular diseases.
 During chemotherapy, a progressive increase in the prooxidant-antioxidant imbalance was observed in multiple myeloma patients. This was evidenced by a 1.4-fold decrease in catalase activity (p<0.05) compared to the initial examination.