title: Effect of high-dose melphalan and peripheral blood stem cell transplantation on renal function in patients with multiple myeloma and renal insufficiency: a case report and review of the literature.
abstract: Multiple myeloma with IgG-lambda monoclonal gammopathy and severe renal impairment with light-chain deposit disease was diagnosed in a 51-year-old man. Following conventional therapy with VAD (vincristine, adriamycin, dexamethasone) a partial remission was achieved. Peripheral blood stem cells (PBSC) were then collected following mobilization with cyclophosphamide and recombinant human granulocyte colony-stimulating factor and enriched for CD34-positive cells by immunoaffinity column. Fourteen months after diagnosis high-dose melphalan was given, followed by infusion of CD34-positive PBSC. Aside from mild oral mucositis and trigonitis, high-dose therapy was tolerated well. After he underwent PBSC transplantation his renal function improved, and the patient has been in in continuous complete remission for 1 year. Thus, high-dose chemotherapy can be safely administered to patients with multiple myeloma and severe renal impairment. Our findings confirm previous reports summarized in the current presentation.
authors.affiliation: Department of Medicine I, University of Vienna, Austria.
authors.forename: E
authors.initials: E
authors.lastname: Reiter
authors.forename: P
authors.initials: P
authors.lastname: Kalhs
authors.forename: F
authors.initials: F
authors.lastname: Keil
authors.forename: W
authors.initials: W
authors.lastname: Rabitsch
authors.forename: H
authors.initials: H
authors.lastname: Gisslinger
authors.forename: G
authors.initials: G
authors.lastname: Mayer
authors.forename: N
authors.initials: N
authors.lastname: Worel
authors.forename: K
authors.initials: K
authors.lastname: Lechner
authors.forename: H T
authors.initials: HT
authors.lastname: Greinix
mesh_terms: D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008558:Melphalan / Q000008:administration & dosage*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications* / Q000503:physiopathology*; D051437:Renal Insufficiency / Q000150:complications* / Q000503:physiopathology*
chemical_list: D018906:Antineoplastic Agents, Alkylating; D008558:Melphalan