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Autologous hematopoietic cell transplantation for multiple myeloma patients with renal insufficiency: A Center for International Blood and Marrow Transplant Research Analysis
Autologous hematopoietic cell transplantation (AHCT) in multiple myeloma (MM) patients with renal insufficiency (RI) is controversial. Patients who underwent AHCT for MM between 2008-2013 were identified (N =1492) and grouped as normal/mild (≥60 ml/min), N=1240, moderate (30-59), N=185 and severe RI...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859934/ https://www.ncbi.nlm.nih.gov/pubmed/28920949 http://dx.doi.org/10.1038/bmt.2017.198 |
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author | Mahindra, Anuj Hari, Parameswaran Fraser, Raphael Fei, Mingwei Huang, Jiaxing Berdeja, Jesus Callander, Natalie Costa, Luciano Diaz, Miguel Angel Freytes, Cesar Gale, Robert Peter Girnius, Saulius Holmberg, Leona Kharfan-Dabaja, Mohamad Kumar, Shaji Kyle, Robert Lazarus, Hillard Lee, Cindy Maiolino, Angelo Moreb, Jan Nishihori, Taiga Pawarode, Attaphol Saad, Ayman Savani, Bipin N. Schriber, Jeffrey William, Basem Wirk, Baldeep M. Krishnan, Amrita Nieto, Yago D’Souza, Anita |
author_facet | Mahindra, Anuj Hari, Parameswaran Fraser, Raphael Fei, Mingwei Huang, Jiaxing Berdeja, Jesus Callander, Natalie Costa, Luciano Diaz, Miguel Angel Freytes, Cesar Gale, Robert Peter Girnius, Saulius Holmberg, Leona Kharfan-Dabaja, Mohamad Kumar, Shaji Kyle, Robert Lazarus, Hillard Lee, Cindy Maiolino, Angelo Moreb, Jan Nishihori, Taiga Pawarode, Attaphol Saad, Ayman Savani, Bipin N. Schriber, Jeffrey William, Basem Wirk, Baldeep M. Krishnan, Amrita Nieto, Yago D’Souza, Anita |
author_sort | Mahindra, Anuj |
collection | PubMed |
description | Autologous hematopoietic cell transplantation (AHCT) in multiple myeloma (MM) patients with renal insufficiency (RI) is controversial. Patients who underwent AHCT for MM between 2008-2013 were identified (N =1492) and grouped as normal/mild (≥60 ml/min), N=1240, moderate (30-59), N=185 and severe RI (<30), N=67 based on MDRD. Multivariate analysis of non-relapse mortality (NRM), relapse, progression-free survival (PFS) and overall survival (OS) was performed. Of the 67 patients with severe RI, 35 were on dialysis prior to AHCT. Patients received melphalan 200 mg/m(2) (Mel200) in 92% (normal/mild), 75% (moderate) and 33% (severe) RI; remainder received 140 mg/m2 (Mel140). Thirty four of 35 patients with severe RI achieved post-AHCT dialysis independence. The 5-year PFS for normal, moderate and severe RI was 35 (95% CI, 31-38)%, 40 (31-49)% and 27 (15-40)% respectively, (p=0·42); 5-year OS for normal, mod and severe RI was 68 (65-71)%, 68 (60-76)% and 60 (46-74)% respectively, (p=0·69). With moderate RI, 5-year PFS for HDM 140 mg/m(2) was 18 (6-35)% and for Mel200 was 46 (36-57)% (p=0·009). With severe RI, 5-year PFS Mel140 was 25 (11-41) % and for Mel200 was 32 (11-58)% (p=0·37). We conclude that AHCT is safe and effective in patients with MM with RI. |
format | Online Article Text |
id | pubmed-5859934 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
record_format | MEDLINE/PubMed |
spelling | pubmed-58599342018-03-21 Autologous hematopoietic cell transplantation for multiple myeloma patients with renal insufficiency: A Center for International Blood and Marrow Transplant Research Analysis Mahindra, Anuj Hari, Parameswaran Fraser, Raphael Fei, Mingwei Huang, Jiaxing Berdeja, Jesus Callander, Natalie Costa, Luciano Diaz, Miguel Angel Freytes, Cesar Gale, Robert Peter Girnius, Saulius Holmberg, Leona Kharfan-Dabaja, Mohamad Kumar, Shaji Kyle, Robert Lazarus, Hillard Lee, Cindy Maiolino, Angelo Moreb, Jan Nishihori, Taiga Pawarode, Attaphol Saad, Ayman Savani, Bipin N. Schriber, Jeffrey William, Basem Wirk, Baldeep M. Krishnan, Amrita Nieto, Yago D’Souza, Anita Bone Marrow Transplant Article Autologous hematopoietic cell transplantation (AHCT) in multiple myeloma (MM) patients with renal insufficiency (RI) is controversial. Patients who underwent AHCT for MM between 2008-2013 were identified (N =1492) and grouped as normal/mild (≥60 ml/min), N=1240, moderate (30-59), N=185 and severe RI (<30), N=67 based on MDRD. Multivariate analysis of non-relapse mortality (NRM), relapse, progression-free survival (PFS) and overall survival (OS) was performed. Of the 67 patients with severe RI, 35 were on dialysis prior to AHCT. Patients received melphalan 200 mg/m(2) (Mel200) in 92% (normal/mild), 75% (moderate) and 33% (severe) RI; remainder received 140 mg/m2 (Mel140). Thirty four of 35 patients with severe RI achieved post-AHCT dialysis independence. The 5-year PFS for normal, moderate and severe RI was 35 (95% CI, 31-38)%, 40 (31-49)% and 27 (15-40)% respectively, (p=0·42); 5-year OS for normal, mod and severe RI was 68 (65-71)%, 68 (60-76)% and 60 (46-74)% respectively, (p=0·69). With moderate RI, 5-year PFS for HDM 140 mg/m(2) was 18 (6-35)% and for Mel200 was 46 (36-57)% (p=0·009). With severe RI, 5-year PFS Mel140 was 25 (11-41) % and for Mel200 was 32 (11-58)% (p=0·37). We conclude that AHCT is safe and effective in patients with MM with RI. 2017-09-18 2017-12 /pmc/articles/PMC5859934/ /pubmed/28920949 http://dx.doi.org/10.1038/bmt.2017.198 Text en Users may view, print, copy, and download text and data-mine the content in such documents, for the purposes of academic research, subject always to the full Conditions of use: http://www.nature.com/authors/editorial_policies/license.html#terms |
spellingShingle | Article Mahindra, Anuj Hari, Parameswaran Fraser, Raphael Fei, Mingwei Huang, Jiaxing Berdeja, Jesus Callander, Natalie Costa, Luciano Diaz, Miguel Angel Freytes, Cesar Gale, Robert Peter Girnius, Saulius Holmberg, Leona Kharfan-Dabaja, Mohamad Kumar, Shaji Kyle, Robert Lazarus, Hillard Lee, Cindy Maiolino, Angelo Moreb, Jan Nishihori, Taiga Pawarode, Attaphol Saad, Ayman Savani, Bipin N. Schriber, Jeffrey William, Basem Wirk, Baldeep M. Krishnan, Amrita Nieto, Yago D’Souza, Anita Autologous hematopoietic cell transplantation for multiple myeloma patients with renal insufficiency: A Center for International Blood and Marrow Transplant Research Analysis |
title | Autologous hematopoietic cell transplantation for multiple myeloma patients with renal insufficiency: A Center for International Blood and Marrow Transplant Research Analysis |
title_full | Autologous hematopoietic cell transplantation for multiple myeloma patients with renal insufficiency: A Center for International Blood and Marrow Transplant Research Analysis |
title_fullStr | Autologous hematopoietic cell transplantation for multiple myeloma patients with renal insufficiency: A Center for International Blood and Marrow Transplant Research Analysis |
title_full_unstemmed | Autologous hematopoietic cell transplantation for multiple myeloma patients with renal insufficiency: A Center for International Blood and Marrow Transplant Research Analysis |
title_short | Autologous hematopoietic cell transplantation for multiple myeloma patients with renal insufficiency: A Center for International Blood and Marrow Transplant Research Analysis |
title_sort | autologous hematopoietic cell transplantation for multiple myeloma patients with renal insufficiency: a center for international blood and marrow transplant research analysis |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859934/ https://www.ncbi.nlm.nih.gov/pubmed/28920949 http://dx.doi.org/10.1038/bmt.2017.198 |
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