Evaluation of serum levels of selected cytokine receptors in adult B-cell precursor acute lymphoblastic leukemia and their association with prognostic factors and survival.

AIM: To evaluate serum levels of selected cytokine receptors in B-cell precursor acute lymphoblastic leukemia (B-ALL) and their association with acknowledged prognostic factors, relapse-free survival (RFS) and overall survival (OS). MATERIALS AND METHODS: A total of 42 de novo adult B-ALL patients, 19 BCR/ABL positive, were included in this study. Soluble receptor α for IL-2 (sIL-2Rα), soluble receptor for IL-6 (sIL-6R), soluble receptor for TNF-α type I and II (sTNFR-1, sTNFR-2) and matrix metalloproteinase-9 (MMP-9) were measured by biochip array technology at diagnosis and in complete remission (CR). RESULTS: At diagnosis of B-ALL, we found significantly higher levels of sIL-2Rα, sIL-6R, sTNFR-1, sTNFR-2 and significantly lower levels MMP-9 in comparison with CR (p < 0.001 in all cases). BCR/ABL positive patients had higher levels of sIL-2Rα at diagnosis (r = 0.484; p = 0.014). Serum levels of evaluated cytokines were not associated with achievement of CR after one cycle of induction therapy, RFS or OS. CONCLUSION: Serum levels of all evaluated cytokines are significantly altered in newly diagnosed B-ALL reflecting activity of the disease. No significant correlations with response to first induction therapy, RFS or OS were found. Further studies with a longer follow-up will be needed.

Olfactory sensitivity in mammalian species.

Olfaction enables most mammalian species to detect and discriminate vast numbers of chemical structures called odorants and pheromones. The perception of such chemical compounds is mediated via two major olfactory systems, the main olfactory system and the vomeronasal system, as well as minor systems, such as the septal organ and the Grueneberg ganglion. Distinct differences exist not only among species but also among individuals in terms of their olfactory sensitivity; however, little is known about the mechanisms that determine these differences. In research on the olfactory sensitivity of mammals, scientists thus depend in most cases on behavioral testing. In this article, we reviewed scientific studies performed on various mammalian species using different methodologies and target chemical substances. Human and non-human primates as well as rodents and dogs are the most frequently studied species. Olfactory threshold studies on other species do not exist with the exception of domestic pigs. Olfactory testing performed on seals, elephants, and bats focused more on discriminative abilities than on sensitivity. An overview of olfactory sensitivity studies as well as olfactory detection ability in most studied mammalian species is presented here, focusing on comparable olfactory detection thresholds. The basics of olfactory perception and olfactory sensitivity factors are also described.

Biochip array technology and evaluation of serum levels of multiple cytokines and adhesion molecules in patients with newly diagnosed acute myeloid leukemia.

AIM: Evaluation of serum levels of 17 cytokines and 5 adhesion molecules in patients with newly diagnosed acute myeloid leukemia (AML) and in healthy subjects using biochip array technology. METHODS: A total of 15 AML patients and 15 healthy subjects (blood donors) were studied. Serum samples were analyzed by biochip based immunoassays on the Evidence Investigator analyzer. This approach allows multi-analytical determination from a single sample. T-tests were used for statistical analysis. RESULTS: In newly diagnosed AML patients, we found significant increase (p < 0.01) in serum VCAM-1, ICAM-1, E-selectin, L-selectin, and significant increase (p < 0.05) in serum IL-6, IL-8. No significant differences were found in the levels of other evaluated cytokines and adhesion molecules. CONCLUSION: Our results indicate that serum levels of specific cytokines and adhesion molecules (VCAM-1, ICAM-1, E-selectin, L-selectin, IL-6, IL-8) are significantly altered in patients with newly diagnosed AML, showing activity of the disease. Whether these alterations could serve as a prognostic marker for AML is not known. Further studies will be needed to define the potential role of these and additional markers in the risk stratification of AML.

Glycogen phosphorylase BB as a potential marker of cardiac toxicity in patients treated with anthracyclines for acute leukemia.

OBJECTIVES: The aim of the presented study was to assess plasma glycogen phosphorylase BB (GPBB) concentrations in acute leukemia patients treated with anthracycline containing chemotherapy. BACKGROUND: Anthracyclines represent the highest risk for development of cardiotoxicity. GPBB belongs to proposed biomarkers of cardiac injury with a very limited experience in this context. METHODS: Totally, 24 adult patients with acute leukemia were enrolled. Plasma GPBB concentrations were measured by ELISA at diagnosis (before chemotherapy), after first chemotherapy with anthracyclines and 6 months after the completion of treatment. The cut-off value for GPBB positivity was 10.00 µg/L as recommended by the manufacturer. RESULTS: Before chemotherapy, the mean plasma GPBB concentration was 5.25±3.81 µg/L, increased above the cut-off in 1 patient (4.2 %). After the first chemotherapy, the mean GPBB was 6.61±5.54 µg/L, positive in 7 (29.2 %) patients. Six months after treatment, the mean GPBB was 10.06±11.41 µg/L, positive in 8 (33.3 %) patients. Six months after treatment, we found a significant correlation between elevation in GPBB and diastolic left ventricular dysfunction on echocardiography (r=0.621; p<0.0001). The differences in plasma GPBB between healthy blood donors and patients treated for acute leukemia were statistically significant (p<0.01 in all cases). CONCLUSION: Our results suggested that GPBB could become a potential biomarker for detection of acute and chronic cardiotoxicity associated with anthracycline containing chemotherapy. The predictive value for development of treatment-related cardiomyopathy in future is not clear and will be evaluated during the follow-up. Further studies are needed to define the potential role of GPBB and other biomarkers in the assessment of chemotherapy-induced cardiotoxicity (Ref. 21). Text in PDF www.elis.sk.

Evaluation of serum levels of multiple cytokines and adhesion molecules in patients with newly diagnosed acute lymphoblastic leukemia using biochip array technology.

AIM: Evaluation of serum levels of 17 cytokines and 5 adhesion molecules in patients with acute lymphoblastic leukemia (ALL) and in healthy subjects using biochip array technology. This approach allows multi-analytical determination from a single sample. METHODS: A total of 15 ALL patients and 15 healthy subjects (blood donors) were studied. Serum samples were analyzed by biochip based immunoassays on the Evidence Investigator analyzer. T-tests were used for statistical analysis. RESULTS: Comparing cytokine and adhesion molecule levels in ALL patients and in healthy subject, we found significant increase in serum VCAM-1 (p < 0.000001), ICAM-1 (p < 0.0001), L-selectin (p < 0.0001), IL-8 (p < 0.001), MCP-1 (p < 0.01), and significant decrease (p < 0.01) in serum IL-3 and IL-4. CONCLUSION: Our results indicate that serum levels of specific cytokines and adhesion molecules (VCAM-1, ICAM-1, L-selectin, IL-8, IL-3, IL-4, MCP-1) are significantly altered in patients with newly diagnosed ALL, reflecting acti-vity of the disease. Further investigation is needed to establish if these alterations could be used as a prognostic indicator for ALL.

Identification of prognostic factors predicting outcome in Hodgkin's lymphoma patients relapsing after autologous stem cell transplantation.

BACKGROUND: High-dose chemotherapy followed by autologous stem cell transplantation (ASCT) is the standard of care for patients with relapsed Hodgkin's lymphoma (HL). However, there is currently little information on the predictors of outcome for patients whose disease recurs after ASCT. METHODS: Five hundred and eleven adult patients with relapsed HL after ASCT from EBMT-GITMO databases were reviewed. RESULTS: Treatments administered following ASCT failure included conventional chemotherapy and/or radiotherapy in 294 (64%) patients, second ASCT in 35 (8%), and alloSCT in 133 (29%). After a median follow-up of 49 months, overall survival (OS) was 32% at 5 years. Independent risk factors for OS were early relapse (<6 months) after ASCT, stage IV, bulky disease, poor performance status (PS), and age ≥50 years at relapse. For patients with no risk factors OS at 5 years was 62% compared with 37% and 12% for those having 1 and ≥2 factors, respectively. This score was also predictive for outcome in each group of rescue treatment after ASCT failure. CONCLUSION(S): Early relapse, stage IV, bulky disease, poor PS, and age ≥50 years at ASCT failure are relevant factors for outcome that may help to understand the results of different therapeutic approaches.

The first determination of Trichuris sp. from roe deer by amplification and sequenation of the ITS1-5.8S-ITS2 segment of ribosomal DNA.

Trichuris nematodes were isolated from roe deer (Capreolus capreolus). At first, nematodes were determined using morphological and biometrical methods. Subsequently genomic DNA was isolated and the ITS1-5.8S-ITS2 segment from ribosomal DNA (RNA) was amplified and sequenced using PCR techniques. With u sing morphological and biometrical methods, female nematodes were identified as Trichuris globulosa, and the only male was identified as Trichuris ovis. The females were classified into four morphotypes. However, analysis of the internal transcribed spacers (ITS1-5.8S-ITS2) of specimens did not confirm this classification. Moreover, the female individuals morphologically determined as T. globulosa were molecularly identified as Trichuris discolor. In the case of the only male molecular analysis match the result of the molecular identification. Furthermore, a comparative phylogenetic study was carried out with the ITS1 and ITS2 sequences of the Trichuris species from various hosts. A comparison of biometric information from T. discolor individuals from this study was also conducted.

Sexual dysfunction in females treated with peripheral blood progenitor cell transplantation: review of literature.

BACKGROUND: Peripheral blood progenitor cell transplantation (PBPCT) is a therapeutic modality used in the anti-tumorous treatment of hemato-oncological diseases and solid tumors. Apart of that, it is also used in therapy of non-malignant and hereditary diseases. AIM: As is the case with other treatments, PBPCT also affects not only the disease process but also the quality of life (QoL). MATERIALS AND METHODS: In the last decade of 20th century, several QoL studies among patients treated with PBPCT were undertaken and an influence on particular dimensions of QoL was observed. One of closely watched aspects was sexuality in patients treated with PBPCT. RESULTS: Sexuality and its expression belong to very important aspects of human behavior. It is also a very sensitive and sensible aspect, so with no doubts it is affected by the diagnosis of neoplasm and cancer treatment. CONCLUSION: Physical and psychosocial factors of PBPCT do affect patient's sexuality and sexual functioning as part of QoL. They remain in focus because of the complex care of patients treated with PBPCT (Fig. 2, Ref. 21).

The use of cardiac biomarkers in detection of cardiotoxicity associated with conventional and high-dose chemotherapy for acute leukemia.

AIM: Monitoring of cardiotoxicity of conventional and high-dose chemotherapy (HD-CT) with multiple biomarkers of cardiac injury - glycogen phosphorylase BB (GPBB), heart-type fatty acid binding protein (H-FABP), cardiac troponins (cTnT, cTnI), creatine kinase MB (CK-MB mass), myoglobin. METHODS: A total of 47 adult acute leukemia patients were studied - 24 patients treated with conventional CT containing anthracyclines (ANT) and 23 patients treated with HD-CT (myeloablative preparative regimen) followed by hematopoietic cell transplantation (HCT). Cardiac biomarkers were assessed prior to treatment (before CT/HD-CT), after first CT with ANT, after last CT with ANT in the first group, after HD-CT and after HCT in the second group. Values above the reference range were considered elevated. RESULTS: Before CT/HD-CT, all biomarkers of cardiac injury were below the cut-offs in all patients. GPBB increased above the cut-off (7.30 microg/L) in 4 (16.7%) patients after first CT and in 5 (20.8%) patients after last CT with ANT. GPBB increased above the cut-off in 5 (21.7%) patients after HD-CT and remained elevated in 5 (21.7%) patients after HCT. CTnI became elevated (above 0.40 microg/L) in 2 (8.3%) patients after first and last CT with ANT. Both patients with cTnI positivity had elevated GPBB. Other tested biomarkers remained below the cut-offs during the study. CONCLUSION: Our results suggest that GPBB could become a sensitive biomarker for detection of acute cardiotoxicity associated with conventional CT containing ANT and HD-CT followed by HCT. The predictive value for development of cardiomyopathy in the future is not known and should be evaluated during a prospective follow-up. Based on our data, a larger prospective and multicenter study would be most desirable to define the potential role of new circulating biomarkers in the assessment of cardiotoxicity in oncology.

Screening for depression in survivors of metastatic ovarian cancer in a programme of palliative cancer care.

BACKGROUND: Depression is seen in many cancer patients. It occurs in approximately 25% of palliative care patients. MATERIALS AND METHODS: This study was local, prospective and cross-sectional. It was carried at Department of Clinical Oncology and Radiation Therapy of Charles University Hospital and Faculty of Medicine in Hradec Králové, Czech Republic. RESULTS: The incidence of depression was 83.3% (25 of all 30 survivors). The relevance of depression is characterized: severely depressed was proved in 9 of all 30 survivors, the moderately depressed in 5 of all 30 survivors, the mildly depressed in 11 of all 30 survivors and normal range in 5 of all 30 survivors. The statistical evaluation not presents statistically significant dependence of ZSRDS on smoking abuse, marital status, age, number of associated diseases and type of palliative cancer care. CONCLUSION: The results of the pilot depression study showed that subsist clear association between metastatic ovarian cancer and depression (Fig. 2, Ref. 30). Full Text (Free, PDF) www.bmj.sk.

Assessment of anthracycline-induced cardiotoxicity with electrocardiography.

AIM: Monitoring of anthracycline-induced cardiotoxicity with electrocardiography (ECG) and comparing ECG changes with findings on echocardiography (ECHO). METHODS: A total of 26 adult acute leukemia patients (mean age 46.2 -/+ 12.4 years, 15 males) treated with 2-6 cycles of anthracycline-based chemotherapy (CT) were studied. Cardiac evaluation was performed at the baseline (before CT), after first CT, after last CT (cumulative anthracycline dose 464.3 -/+ 117.5 mg/m2) and circa 6 months after CT. Time ECG parameters, QRS voltage, presence of repolarization changes, arrhythmias and other abnormalities were evaluated. RESULTS: During treatment and follow-up, we found a statistical significant QTc interval prolongation - 414.7 -/+ 16.0 ms (before CT), 419.6 -/+ 21.6 ms (after first CT), 428.0 -/+ 16.2 ms (after last CT) and 430.1 -/+ 18.4 ms (6 months after CT). Significant QTc interval prolongation (> 450 ms) occurred in 3 patients after first CT, in 4 patients after last CT and in 5 patients within 6 months after CT. Significant total QRS voltage lowering in the limb leads (> 1.0 mV versus before CT) occurred in 3 patients after first CT, in 5 patients after last CT and in 6 patients within 6 months after CT. We found a statistically significant correlation between decreased QRS voltage, QTc interval prolongation and left ventricular (LV) dysfunction on ECHO. Repolarization changes associated with oncology treatment were present in 9 patients within 6 months after CT. CONCLUSION: Anthracycline treatment is associated with changes in electrical activity of the myocardium. Prolonged QTc interval represents a risk for development of malignant ventricular arrhythmias. Decreased QRS voltage and prolonged QTc interval after anthracycline treatment could correlate with LV dysfunction on ECHO. Further studies will be needed to prove whether these ECG changes could serve as an accessible and non-invasive screening method indicating LV dysfunction after anthracycline treatment.

Cardiovascular changes associated with infusion of hematopoietic cell grafts in oncohematological patients -- impact of cryopreservation with dimethylsulfoxide.

AIM: Dimethylsulfoxide (DMSO) is the most frequently used agent for hematopoietic cell (HC) graft cryopreservation. This study aimed to monitor blood pressure and heart rate (HR) during HC graft infusion and assess the impact of cryopreservation with DMSO. METHODS: 153 HC graft infusions in 153 consecutive hematological patients (mean age 49.1 -/+ 12.6 years; 80 males) were evaluated. Cryopreservation with DMSO was used in 133 grafts (DMSO group). Twenty grafts were infused directly without cryopreservation (control group). Systolic blood pressure (SBP), diastolic blood pressure (DBP) and HR were measured immediately before and after HC graft infusion. RESULTS: SBP and DBP increased significantly after graft infusions cryopreserved with DMSO ( p<0.0001 for SBP; p<0.01 for DBP). Increases (> 10mmHg) in SBP were seen in 42 (31.6%) patients; in DBP in 31 (23.3%) patients. Changes in HR were non-significant in DMSO group. Increases in BP and HR correlated with increasing DMSO dose (p<0.01; p<0.05, respectively). Changes in SBP, DBP and HR were non-significant in control group. CONCLUSION: HC graft infusions cryopreserved with DMSO could cause statistically significant increases in SBP and DBP, without changes in HR. These changes were mostly transient and asymptomatic, not requiring therapeutic intervention. However, they might cause complications, especially in patients with preexisting cardiovascular disease, who should be monitored closely during HC transplantation.

Multimarker approach to evaluation of cardiac toxicity during preparative regimen and hematopoietic cell transplantation.

Cardiac toxicity of preparative regimen (PR) containing high-dose Cyclophosphamide (120 mg/kg) followed by hematopoietic cell transplantation (HCT) was evaluated with 6 biomarkers of cardiac injury: N-terminal pro brain natriuretic peptide (NT-proBNP), creatine kinase MB (CK-MB mass), cardiac troponins (cTnT, cTnI), heart-type fatty acid binding protein (H-FABP), glycogen phosphorylase BB (GPBB). Twenty-three patients (mean age 44.5+/-10.6 years, 15 males) with acute leukemia were studied. All biomarkers were measured the day before PR, the day after PR, the day after HCT and 14 days after HCT. We found NT-proBNP elevations above 500 ng/L in 6 (26.1 %) patients after PR, in 9 (39.1 %) after HCT and in 7 (30.4 %) 14 days after HCT. GPBB became elevated (above 7.30 microg/L) in 5 (21.7 %) patients after PR, remained elevated in 5 (21.7 %) after HCT and in 2 (8.7 %) 14 days after HCT. A significant correlation between elevation in NT-proBNP and GPBB was found. Other markers remained within the reference range early after PR and HCT. Our findings show that administration of PR and HCT for acute leukemia is associated with acute neurohumoral activation of cardiac dysfunction (significant rise in NT-proBNP) and may lead to GPBB elevation. These changes could indicate acute cardiac toxicity due to treatment and require further follow-up. The predictive value for development of cardiomyopathy in the future is unclear. Further studies will be needed to define the potential role of new biomarkers in this context.

Quality of life and arterial endovascular intervention by means of balloon angioplasty.

AIM: The aim of this study was to evaluate the quality of life (QoL) and the effect of arterial balloon angioplasty (ABA) on QoL of patients with peripheral arterial occlusive disease (PAOD). METHODS: The study is a prospective and longitudinal one and was carried out at the 2nd Internal Clinic of Charles University Hospital in Hradec Kralove, Czech Republic. Forty-two patients with PAOD, hospitalized for the endovascular intervention by means of percutaneous transluminal angiography, were evaluated for QoL. Thirty patients with PAOD (20 male, 10 female) were treated by endovascular intervention by means of ABA. The evaluation of QoL was performed by means of the Czech version of the international generic European Quality of Life Questionnaire EQ-5D. Statistical analysis was determined by means of analysis of variance and paired t-test. The QoL questionnaires were evaluated by means of descriptive analysis. RESULTS: The study has shown the following results: patients with PAOD had low global QoL; a statistically significant relation between QoL of patient with PAOD and the their age (P<0.01); a statistically significant relation between global QoL and stage of PAOD by Fontaine classification (P<0.01); and a statistically significant relation between global QoL and ABA (P<0.0001). CONCLUSION: The QoL of patients with PAOD is low. The QoL is lower with increasing age and with severity of PAOD. The results show the existence of a positive effect of ABA on QoL in patients with PAOD.

Use of multiple biomarkers for evaluation of anthracycline-induced cardiotoxicity in patients with acute myeloid leukemia.

AIM: To assess cardiac toxicity of anthracycline treatment with six biomarkers of cardiac injury: myoglobin, creatine kinase MB (CK-MB mass), cardiac troponin T (cTnT), cardiac troponin I (cTnI), heart-type fatty acid binding protein (H-FABP), glycogen phosphorylase BB (GPBB). METHODS: We evaluated anthracycline-induced cardiotoxicity in 12 acute myeloid leukemia patients (mean age 51.3-/+10.7 years, 7 females). All biomarkers were measured at the baseline, after first chemotherapy (CT) with anthracyclines, after last CT with anthracyclines (total cumulative dose 479.8-/+106.2 mg/m2) and 6 months thereafter. Values above the reference range were considered elevated. RESULTS: GPBB increased above the cut-off (7.30 microg/L) in 2 (16.7%) patients after first CT, in 3 (25.0%) patients after last CT and remained elevated in 2 (16.7%) patients within 6 months after CT. CTnI became elevated (above 0.40 microg/L) in 1 (8.3%) patient after first and last CT and within 6 months after CT. CTnT remained negative (below 0.01 microg/L) during CT in all patients. Six months after CT, delayed cTnT positivity was found in 1 (8.3%) patient. All patients with cTnI or cTnT positivity had elevated GPBB. Other biomarkers (myoglobin, CK-MB mass, H-FABP) remained within the reference range in all patients. CONCLUSION: Our preliminary results suggest that GPBB could be a new promising marker for detection of anthracycline-related cardiotoxicity and probably superior to cardiac troponins. The predictive value for development of cardiomyopathy in the future is not clear and will be evaluated during a prospective follow-up.

Monitoring of the very early changes of left ventricular diastolic function in patients with acute leukemia treated with anthracyclines.

AIM: To analyze the very early changes of diastolic LV function during and after chemotherapy (CT) in patients with newly diagnosed acute leukemia. METHODS: 26 patients with acute leukemia have been studied. The cardiac echo evaluation was performed at the baseline (before CT), after the first CT (mean cumulative anthracyclines dose 136.3-/+28.3 mg m(-2)), after the last CT (mean cumulative anthracyclines dose 464.3-/+117.5 mg m(-2)) and circa 6 months after the completion of CT. RESULTS: We found a significant decrease in LVEF (65.3-/+4.5' vs 60.2-/+5.7', p<0.01), the fractional shortening of the LV (34.8-/+3.7', vs 29.5-/+5.0', p<0.01), but the mitral flow rapid filling velocity (E-wave) was not changed (0.74-/+0.18 ms(-1), vs 0.67-/+0.17 ms(-1), p ns), and atrial filling velocity (A-wave) increased (0.66-/+0.15 ms(-1) vs 0.78-/+0.18 ms(-1), p<0.01). E/A ratio significantly decreased (1.18-/+0.35 vs 0.89-/+0.27, p<0.01). IVRT increased (71.5-/+11.6 ms vs 84.0-/+11.6 ms, p<0.01). DT E-wave velocity increased (162.3-/+25.8 ms vs 206.7-/+25.5 ms, p<0.01). After the first CT, the signs of LV diastolic dysfunction were detected in 5 (19.2') patients. 6 months after the last CT, two of these patients (7.7') developed LV systolic dysfunction with the clinical symptoms of heart failure. Six months after the last CT, 12 (46.2') patients developed the signs of LV diastolic dysfunction. CONCLUSION: Chemotherapy can induce early changes of diastolic left ventricular function. We consider using Doppler echocardiography as the election tool not only for baseline cardiologic screening but also for the monitoring of the earliest subclinical signs of cardiotoxicity.

Health-related quality of life in multiple myeloma survivors treated with high dose chemotherapy followed by autologous peripheral blood progenitor cell transplantation: a retrospective analysis.

A pilot study analyses an effect of selected demographic, psychosocial and health aspects on quality of life (QoL) in multiple myeloma survivors treated with high-dose chemotherapy followed by autologous peripheral blood progenitor cell transplantation (PBPCT). The total number of respondents with multiple myeloma treated with high-dose chemotherapy followed by autologous PBPCT between years 2001-2003 at the Department of Clinical Haematology of the 2nd Department of Internal Medicine of Charles University Hospital and Faculty of Medicine in Hradec Králové, Czech Republic was 32 (18 male, 14 female). The average age of respondents was 60 years old. The Czech version of an international generic European Quality of Life Questionnaire - Version EQ-5D was used. The effect of selected demographics, psychosocial and health aspects on QoL was determined by means of analysis of variance (ANOVA). The QoL questionnaires were evaluated by means of descriptive analysis. The above-mentioned aspects proved statistically significant dependence of QoL on respondents age and on smoking abuse. EQ-5D score (dimensions of QoL) and EQ-5D VAS (a subjective health condition) significantly decrease with increasing age and with smoking abuse. The effect of other aspects on QoL was not proven as statistically significant. Prevailing complaints in respondents with multiple myeloma were: 1. regular activity with complaints 81,2 % (26/32 respondents), 2. medium serious pain / discomfort 68,8 % (22/32 respondents), 3. movement with complaints 59 % (19/32 respondents), 4. medium serious anxiety / depression 59 % (19/32 respondents). The QoL in patients with multiple myeloma treated with high-dose chemotherapy followed by autologous PBPCT was on low level (mean EQ-5D score was 68,9 %, mean EQ-5D VAS was 66,6 %). The results had shown that with an increasing age, the QoL of patients with multiple myeloma treated with high-dose chemotherapy followed by autologous PBPCT, declines. The smokers and former smokers have lower QoL than non smokers. The global QoL in all studied patients with multiple myeloma treated with high-dose chemotherapy followed by autologous PBPCT was on low level.