Among the infectious complications of MM are acute bronchitis, pneumonia, postpneumonic abscesses . The emergence of inflammatory complications of the bronchopulmonary system in MM, in addition to the above factors, can contribute to impaired microcirculation and changes in the rheological properties of blood . Paraproteinemic hemoblastosis is characterized by increased red blood cell aggregation and impaired blood flow in the capillaries . In addition, with nitrogen-induced uremia in the respiratory tract, deep tissue changes that lead to disruption of the act of breathing due to severe intoxication are detected .
With a long course of MM, respiratory organs are damaged with the development of serosites. Radiographically, this reveals homogeneous darkening in the lung tissue, sometimes an increase in mediastinal lymph nodes, and fluid in the pleural cavity.
Data on the study of respiratory function in patients with MM in the literature are sporadic . The revealed changes indicate a decrease in the vital capacity of the light and its components, a decrease in the partial oxygen stress (pO 2 ). In the work of G.F. Babushkina (1987) revealed a violation of the function of external respiration, mainly of a restrictive type, in 76% of patients with multiple myeloma, especially in those over 50 years old, with a long duration of the disease. According to G.F. Grandmother’s morphological manifestations of a specific process in the lungs (lymphoplasmacytic infiltration, tissue paraproteinosis and paraamyloidosis), detected in 75% of cases, correlate with impaired respiratory function . E.Robin et. al. (1977) report that in patients with paraproteinemic hemoblastosis due to impaired pulmonary blood flow at the level of the microvasculature, the uptake of oxygen by the tissues is disturbed and dysoxia develops. In patients with MM “chained to the bed” due to a pronounced osteo-destructive process in the bones, energy costs are reduced, resulting in redistribution of blood and its deposit in the pulmonary circulation, thus reducing pulmonary ventilation and increasing effective pulmonary blood flow .
V.M. Provotorov and A.Yu. Kazabtsov (1997) studied the features of the course of COPD in patients with MM . The authors found that patients with COPD on the background of MM have pronounced impaired phagocytic activity, impaired cellular and humoral immunity. Against the background of ongoing chemotherapy, disorders of the immune system are exacerbated. Due to the worsening of the defects of the immune system and the formation of persistent secondary immune deficiency, the course of COPD becomes heavier. In patients with COPD on the background of lymphoproliferative diseases, a violation of tracheobronchial cleansing is more pronounced. The authors concluded that it is necessary to include patients with chronic lymphoproliferative tumors with immunocorrective therapy, the use of antibacterial agents that do not have immunosuppressive de- realities, and expositors .