[Treatment and survival of multiple myeloma patients on programmed hemodialysis].
OBJECTIVE
To analyse clinical picture of multiple myeloma (MM) and treatment results in MM patients on programmed dialysis (PD).


METHODS
Case histories of 22 MM patients were analysed. They had a terminal stage of chronic renal failure (CRF) in the onset of the disease. Chemotherapy (CT) was performed in 20 patients (10 patients received VAD program, the other 10--melfalan).


RESULTS
Early lethality was 28%. The patients died of septic complications. Neutropenia was observed significantly more frequently on melfalan treatment than on VAD therapy (9 and 2 patients, respectively; chi-square 5.6; p = 0.009). Survival median, excluding early lethality, was 16 months. Differences by therapy were not registered. Three patients on MP program survived more than 3 years. Function of the kidneys improved in 4 (20%) patients. Hemodialysis was avoided in 2 patients. Survival of patients with reestablished renal function was maximal (44 and 84 months).


CONCLUSIONS
Standard CT for MM with terminal CRF is associated with high toxicity and frequent septic complications. Survival is better if renal function improves and HD discontinues. Reversibility of CRF at a terminal stage in MM does not depend on completeness of hematological response. Programs with melfalan CT provoke more frequent myelotoxic cytopenia, early lethality is higher but the number of longer survivals is more.
Rekhtina
I G
IG
Ryzhko
V V
VV
Chavynchak
R B
RB
Biriukova
L S
LS
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D004317:Doxorubicin / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007676:Kidney Failure, Chronic / Q000209:etiology / Q000628:therapy; D008297:Male; D008558:Melphalan / Q000627:therapeutic use*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000401:mortality* / Q000628:therapy*; D019653:Myeloablative Agonists / Q000627:therapeutic use*; D006435:Renal Dialysis / Q000379:methods; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
D019653:Myeloablative Agonists; D005047:Etoposide; D004317:Doxorubicin; D008558:Melphalan