The outcome of autologous stem cell transplantation in patients with plasma cell disorders and dialysis-dependent renal failure.
Patients with multiple myeloma and end-stage renal failure on dialysis are frequently not considered eligible for high-dose therapy (HDT) due to higher transplant-related mortality (TRM). Our aim was to evaluate the toxicity and survival of dialysis-dependent patients after HDT with melphalan (100 mg/m(2)) compared to those of patients without renal insufficiency (melphalan 200 mg/m(2)) in a matched pairs analysis of 34 patients. No significant differences were observed between hematologic toxicity, TRM or disease response. Dialysis patients showed comparable event-free and overall survival. They required significantly extended intravenous antibiotic treatment and longer hospitalization. Thus, melphalan 100 mg/m2 is less toxic, yet equally efficient and improves the prognosis of this group of patients.
Raab
Marc S
MS
Department of Internal Medicine V, University of Heidelberg, Germany. Marc_Raab@dfci.harvard.edu
Breitkreutz
Iris
I
Hundemer
Michael
M
Benner
Axel
A
Klaus
Jens
J
Hegenbart
Ute
U
Moehler
Thomas
T
Ho
Anthony D
AD
Zeier
Martin
M
Goldschmidt
Hartmut
H
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000628:therapy*; D006435:Renal Dialysis / Q000401:mortality; D033581:Stem Cell Transplantation / Q000401:mortality; D014182:Transplantation, Autologous / Q000401:mortality; D016896:Treatment Outcome