title: Toxicity of a second autologous peripheral blood stem cell transplant in patients with relapsed or recurrent multiple myeloma.
abstract: Toxicity associated with a second autologous peripheral blood stem cell transplant (APBSCT) in patients who relapse following initial APBSCT for multiple myeloma (MM) has not been well described. We conducted a retrospective, case-series of 25 consecutive patients who received a second APBSCT for relapsed or progressive disease following prior APBSCT to describe associated toxicity. Grade 3 or 4 toxicities were observed in 92% of patients after each APBSCT. More patients developed an elevated serum creatinine (4%vs. 36%; p = 0.011) following the second APBSCT. Median time to neutrophil engraftment was 10 days following both transplants (p = 0.428). Platelet engraftment was delayed by 2 days after the second APBSCT (median 12 vs.14 days; p < 0.025). There were two deaths before day 100. In conclusion, patients who undergo a second APBSCT for relapsed MM experience more nephrotoxicity. Delayed platelet engraftment and an 8% treatment-related mortality were observed following the second APBSCT.
authors.affiliation: Department of Pharmacy, South Texas Veterans Healthcare System, San Antonio, TX, USA. burzynski.julianna@mayo.edu
authors.forename: Julianna Aleathea
authors.initials: JA
authors.lastname: Burzynski
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Toro
authors.forename: Rakhi Chhaganbhai
authors.initials: RC
authors.lastname: Patel
authors.forename: Shuko
authors.initials: S
authors.lastname: Lee
authors.forename: Rebecca Elizabeth
authors.initials: RE
authors.lastname: Greene
authors.forename: Jose Leonel
authors.initials: JL
authors.lastname: Ochoa-Bayona
authors.forename: Christopher Raymond
authors.initials: CR
authors.lastname: Frei
authors.forename: Cesar O
authors.initials: CO
authors.lastname: Freytes
mesh_terms: D000328:Adult; D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D036102:Peripheral Blood Stem Cell Transplantation / Q000009:adverse effects*; D012008:Recurrence; D012042:Registries; D012189:Retrospective Studies; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome