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Could renal impairment be a positive predictor of outcome in autografts for myeloma?

Bone Marrow Transplantation volume 51, pages 1305–1306 (2016)Cite this article

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Science that challenges or overturns conventional wisdom, old knowledge or what we intuitively ‘know’ can provide the spark that drives ongoing enquiry and the modernisation of knowledge. There are multiple examples in medicine of such challenges and the paper by Sweiss et al.1 may add to such a list.

In this provocative paper, the stated interpretation of the data is that patients with renal impairment and myeloma who undergo autologous stem cell transplantation (autoSCT) after conditioning with melphalan 200 mg/m2 in fact have improved disease control, despite the observed risk of increased toxicity, with a positive impact on treatment-free survival. This is, of course, the counterintuitive point of the study as it would have been predicted from previous studies in myeloma therapy that poor renal function was associated with inferior outcomes.2, 3

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References

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  1. Department of Clinical Haematology & Bone Marrow Transplant Service Royal Melbourne Hospital, Parkville, Victoria, Australia

    J Szer

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  1. J Szer
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Correspondence to J Szer.

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Szer, J. Could renal impairment be a positive predictor of outcome in autografts for myeloma?. Bone Marrow Transplant 51, 1305–1306 (2016). https://doi.org/10.1038/bmt.2016.138

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