title: Long-term outcome of patients with multiple [corrected] myeloma-related advanced renal failure following auto-SCT.
abstract: Renal failure commonly complicates multiple myeloma (MM) and is associated with reduced survival. It is not clear whether auto-SCT results in improved renal function or attainment of independence from dialysis in patients with advanced renal impairment due to MM. We conducted a retrospective cohort study of all patients who underwent auto-SCT for MM complicated by advanced renal failure at our institution over a 10-year period (2000-2010). We aimed to assess the association between auto-SCT and renal outcome in patients with serum creatinine (SCr) over 3 mg/dL, attributable to MM, including those who were dialysis dependent. Thirty patients (2.8% of all auto-SCT patients) met inclusion criteria. Fourteen of 15 patients who were dialysis dependent before auto-SCT remained dialysis dependent in the long term despite hematological response (HR). Of the remaining 15 patients with SCr >3 mg/dL, an improvement in glomerular filtration rate (GFR) from 15 to 19.4 mL/min/1.73 m(2) was noted post auto-SCT (P=0.035); however, neither HR post auto-SCT or pre-existing renal function were independently associated with renal outcome. Auto-SCT was not associated with independence from dialysis in patients with renal failure due to MM at our institution. Although auto-SCT was associated with an improvement in GFR in patients with SCr >3 mg/dL, this improvement was not related to HR.
authors.affiliation: Department of Hematology, Galway University Hospital, Galway, Ireland.
authors.forename: S V
authors.initials: SV
authors.lastname: Glavey
authors.forename: M A
authors.initials: MA
authors.lastname: Gertz
authors.forename: A
authors.initials: A
authors.lastname: Dispenzieri
authors.forename: S
authors.initials: S
authors.lastname: Kumar
authors.forename: F
authors.initials: F
authors.lastname: Buadi
authors.forename: M
authors.initials: M
authors.lastname: Lacy
authors.forename: S R
authors.initials: SR
authors.lastname: Hayman
authors.forename: P
authors.initials: P
authors.lastname: Kapoor
authors.forename: D
authors.initials: D
authors.lastname: Dingli
authors.forename: A
authors.initials: A
authors.lastname: McCurdy
authors.forename: W J
authors.initials: WJ
authors.lastname: Hogan
authors.forename: D A
authors.initials: DA
authors.lastname: Gastineau
authors.forename: N
authors.initials: N
authors.lastname: Leung
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood / Q000503:physiopathology* / Q000601:surgery*; D011446:Prospective Studies; D051437:Renal Insufficiency / Q000097:blood / Q000209:etiology* / Q000503:physiopathology; D012189:Retrospective Studies; D033581:Stem Cell Transplantation / Q000009:adverse effects / Q000379:methods*; D016019:Survival Analysis; D019172:Transplantation Conditioning / Q000009:adverse effects / Q000379:methods*; D014182:Transplantation, Autologous / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome