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.
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.
Reiter
E
E
Department of Medicine I, University of Vienna, Austria.
Kalhs
P
P
Keil
F
F
Rabitsch
W
W
Gisslinger
H
H
Mayer
G
G
Worel
N
N
Lechner
K
K
Greinix
H T
HT
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*
D018906:Antineoplastic Agents, Alkylating; D008558:Melphalan