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Pulmonary hypertension complicating multiple myeloma

Udhay Krishnan1, Tomer M Mark2, Ruben Niesvizky2

  • 1Division of Cardiology, Weil Cornell Medical College, New York Presbyterian Hospital-Cornell Medical Center, New York, New York, USA.

Pulmonary Circulation
|September 25, 2015
PubMed

Insights

Pulmonary hypertension (PH) is a rare complication of multiple myeloma (MM). This study found severe PH in three MM patients, who improved with vasodilator therapy, suggesting a potential treatment target.

Area of Science:

  • Hematology
  • Cardiology
  • Pulmonology

Background:

  • Pulmonary hypertension (PH) is an uncommon complication of multiple myeloma (MM).
  • PH is more frequently linked to conditions like amyloidosis, myeloproliferative diseases, and POEMS syndrome.
  • In MM, PH is often mild to moderate and multifactorial, including cardiac dysfunction, kidney disease, and treatment side effects.

Observation:

  • This report details three patients with multiple myeloma (MM) who presented with severe pulmonary hypertension (PH).
  • All patients underwent right heart catheterization, confirming elevated pulmonary pressures, transpulmonary gradients, and pulmonary vascular resistance.
  • The observed cases highlight a severe manifestation of PH in the context of MM.

Findings:

  • The three patients with severe PH associated with MM were treated with pulmonary vasodilator therapy.
  • Cardiopulmonary symptoms showed improvement following the initiation of vasodilator treatment.
  • These findings suggest that pulmonary vasodilator therapy may be beneficial for select MM patients with severe PH.

Implications:

  • Further research is essential to determine the prevalence and prognosis of PH in multiple myeloma patients.
  • Understanding the pathogenesis of PH in MM is crucial for identifying patients who could benefit from targeted PH therapies.
  • This study underscores the need for increased awareness and investigation of severe PH as a complication of multiple myeloma.
Keywords:
amyloidosismultiple myelomapulmonary hypertensionpulmonary vasculature

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