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Autografting

Long-term outcome of patients with mutiple myeloma-related advanced renal failure following auto-SCT

A Corrigendum to this article was published on 02 July 2014

Abstract

Renal failure commonly complicates multiple myeloma (MM) and is associated with reduced survival. It is not clear whether auto-SCT results in improved renal function or attainment of independence from dialysis in patients with advanced renal impairment due to MM. We conducted a retrospective cohort study of all patients who underwent auto-SCT for MM complicated by advanced renal failure at our institution over a 10-year period (2000–2010). We aimed to assess the association between auto-SCT and renal outcome in patients with serum creatinine (SCr) over 3 mg/dL, attributable to MM, including those who were dialysis dependent. Thirty patients (2.8% of all auto-SCT patients) met inclusion criteria. Fourteen of 15 patients who were dialysis dependent before auto-SCT remained dialysis dependent in the long term despite hematological response (HR). Of the remaining 15 patients with SCr >3 mg/dL, an improvement in glomerular filtration rate (GFR) from 15 to 19.4 mL/min/1.73 m2 was noted post auto-SCT (P=0.035); however, neither HR post auto-SCT or pre-existing renal function were independently associated with renal outcome. Auto-SCT was not associated with independence from dialysis in patients with renal failure due to MM at our institution. Although auto-SCT was associated with an improvement in GFR in patients with SCr >3 mg/dL, this improvement was not related to HR.

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References

  1. Gertz MA, Lacy MQ, Dispenzieri A, Hayman SR, Kumar S, Leung N et al. Impact of age and serum creatinine value on outcome after autologous blood stem cell transplantation for patients with multiple myeloma. Bone Marrow Transplant 2007; 39: 605–611.

    CAS  Article  Google Scholar 

  2. San Miguel JF, Lahuerta JJ, Garcia-Sanz R, Alegre A, Blade J, Martinez R et al. Are myeloma patients with renal failure candidates for autologous stem cell transplantation? Hematol J 2000; 1: 28–36.

    CAS  Article  Google Scholar 

  3. Blade J, Fernandez-Llama P, Bosch F, Montoliu J, Lens XM, Montoto S et al. Renal failure in multiple myeloma: presenting features and predictors of outcome in 94 patients from a single institution. Arch Intern Med 1998; 158: 1889–1893.

    CAS  Article  Google Scholar 

  4. Knudsen LM, Hippe E, Hjorth M, Holmberg E, Westin J . Renal function in newly diagnosed multiple myeloma—a demographic study of 1353 patients. The Nordic Myeloma Study Group. Eur J Haematol 1994; 53: 207–212.

    CAS  Article  Google Scholar 

  5. Matsue K, Fujiwara H, Iwama K, Kimura S, Yamakura M, Takeuchi M . Reversal of dialysis-dependent renal failure in patients with advanced multiple myeloma: single institutional experiences over 8 years. Ann Hematol 2010; 89: 291–297.

    CAS  Article  Google Scholar 

  6. Dimopoulos MA, Richardson PG, Schlag R, Khuageva NK, Shpilberg O, Kastritis E et al. VMP (Bortezomib, Melphalan, and Prednisone) is active and well tolerated in newly diagnosed patients with multiple myeloma with moderately impaired renal function, and results in reversal of renal impairment: cohort analysis of the phase III VISTA study. J Clin Oncol 2009; 27: 6086–6093.

    CAS  Article  Google Scholar 

  7. Knudsen LM, Hjorth M, Hippe E . Renal failure in multiple myeloma: reversibility and impact on the prognosis. Nordic Myeloma Study Group. Eur J Haematol 2000; 65: 175–181.

    CAS  Article  Google Scholar 

  8. Torra R, Blade J, Cases A, Lopez-Pedret J, Montserrat E, Rozman C et al. Patients with multiple myeloma requiring long-term dialysis: presenting features, response to therapy, and outcome in a series of 20 cases. Br J Haematol 1995; 91: 854–859.

    CAS  Article  Google Scholar 

  9. Attal M, Harousseau JL, Stoppa AM, Sotto JJ, Fuzibet JG, Rossi JF et al. A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. Intergroupe Francais du Myelome. New Engl J Med 1996; 335: 91–97.

    CAS  Article  Google Scholar 

  10. Child JA, Morgan GJ, Davies FE, Owen RG, Bell SE, Hawkins K et al. High-dose chemotherapy with hematopoietic stem-cell rescue for multiple myeloma. New Engl J Med 2003; 348: 1875–1883.

    CAS  Article  Google Scholar 

  11. Parikh GC, Amjad AI, Saliba RM, Kazmi SM, Khan ZU, Lahoti A et al. Autologous hematopoietic stem cell transplantation may reverse renal failure in patients with multiple myeloma. Biol Blood Marrow Transplant 2009; 15: 812–816.

    Article  Google Scholar 

  12. Knudsen LM, Nielsen B, Gimsing P, Geisler C . Autologous stem cell transplantation in multiple myeloma: outcome in patients with renal failure. Eur J Haematol 2005; 75: 27–33.

    Article  Google Scholar 

  13. Badros A, Barlogie B, Siegel E, Roberts J, Langmaid C, Zangari M et al. Results of autologous stem cell transplant in multiple myeloma patients with renal failure. Br J Haematol 2001; 114: 822–829.

    CAS  Article  Google Scholar 

  14. Lee CK, Zangari M, Barlogie B, Fassas A, van Rhee F, Thertulien R et al. Dialysis-dependent renal failure in patients with myeloma can be reversed by high-dose myeloablative therapy and autotransplant. Bone Marrow Transplant 2004; 33: 823–828.

    CAS  Article  Google Scholar 

  15. Levey AS, Bosch JP, Lewis JB, Greene T, Rogers N, Roth D . A more accurate method to estimate glomerular filtration rate from serum creatinine: a new prediction equation. Modification of Diet in Renal Disease Study Group. Ann Intern Med 1999; 130: 461.

    CAS  Article  Google Scholar 

  16. Kyle RA, Gertz MA, Witzig TE, Lust JA, Lacy MQ, Dispenzieri A et al. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc 2003; 78: 21–33.

    Article  Google Scholar 

  17. Ludwig H, Adam Z, Hajek R, Greil R, Tothova E, Keil F et al. Light chain-induced acute renal failure can be reversed by bortezomib-doxorubicin-dexamethasone in multiple myeloma: results of a phase II study. J Clin Oncol 2010; 28: 4635–4641.

    CAS  Article  Google Scholar 

  18. Sonneveld P, Schmidt-Wolf IG, van der Holt B, El Jarari L, Bertsch U, Salwender H et al. Bortezomib induction and maintenance treatment in patients with newly diagnosed multiple myeloma: results of the randomized phase III HOVON-65/ GMMG-HD4 trial. J Clin Oncol 2012; 30: 2946–2955.

    CAS  Article  Google Scholar 

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Correspondence to S V Glavey.

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Glavey, S., Gertz, M., Dispenzieri, A. et al. Long-term outcome of patients with mutiple myeloma-related advanced renal failure following auto-SCT. Bone Marrow Transplant 48, 1543–1547 (2013). https://doi.org/10.1038/bmt.2013.109

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  • DOI: https://doi.org/10.1038/bmt.2013.109

Keywords

  • auto-SCT
  • renal
  • dialysis

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