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Autologous stem cell transplantation in patients with AL amyloidosis with impaired renal function

Bone Marrow Transplantation volume 54, pages 1775–1779 (2019)Cite this article

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Abstract

We retrospectively reviewed the impact of impaired renal function (eGFR < 45 ml/min/SA) on post-transplant outcomes in patients receiving ASCT for AL amyloidosis. Patients were grouped into two cohorts, those with normal renal function (NRF) eGFR ≥ 45 ml/min (n = 568) and those with impaired renal function (IRF) eGFR < 45 ml/min (n = 87). Patients with IRF had higher renal stage (>Stage 1: 100% IRF vs 37% NRF, p < 0.0001) and the majority received conditioning with melphalan <200 mg/m2 (70% IRF vs 21% NRF, p < 0.0001). Forty-four patients (6.7%) required dialysis within 100 days of ASCT. Renal stage predicted for dialysis institution within 100 days of ASCT (3% Stage I vs 10% Stage II vs 22% Stage III, p < 0.0001). Dialysis within 100 days was higher in the IRF cohort (16% for IRF cohort vs 6% for NRF cohort, p = 0.0007. Patients with impaired renal function were more likely to be admitted to hospital (80% IRF vs 70% NRF, p = 0.03). The 100-day mortality was higher in the IRF cohort (14% IRF cohort vs 5% NRF cohort, p = 0.008). Median OS and PFS were similar between the two cohorts. Impaired renal function predicts for a higher rate of hospitalization, progression to dialysis and early mortality in patients receiving ASCT for AL amyloidosis.

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Authors and Affiliations

  1. Division of Hematology, Department of Internal Medicine, Mayo Clinic Rochester, Rochester, MN, USA

    M. Hasib Sidiqi, Kalyan Nadiminti, Abdullah S. Al Saleh, Kapil Meleveedu, Francis K. Buadi, Angela Dispenzieri, Rahma Warsame, Martha Q. Lacy, David Dingli, Nelson Leung, Wilson I. Gonsalves, Prashant Kapoor, Taxiarchis V. Kourelis, William J. Hogan, Shaji K. Kumar & Morie A. Gertz

  2. Department of Hematology, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

    Abdullah S. Al Saleh

  3. Division of Nephrology, Department of Internal Medicine, Mayo Clinic Rochester, Rochester, MN, USA

    Nelson Leung

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  1. M. Hasib Sidiqi
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Correspondence to Morie A. Gertz.

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Sidiqi, M.H., Nadiminti, K., Al Saleh, A.S. et al. Autologous stem cell transplantation in patients with AL amyloidosis with impaired renal function. Bone Marrow Transplant 54, 1775–1779 (2019). https://doi.org/10.1038/s41409-019-0524-2

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