title: Autologous Hematopoietic Stem Cell Transplantation in Dialysis-Dependent Myeloma Patients.
abstract: BACKGROUND
  We retrospectively analyzed our transplant database from July 2000 to June 2012 to identify myeloma patients who received autologous stem cell transplantation while dialysis-dependent.
  
  
  METHODS
  2091 patients underwent autologous high-dose therapy during this period. Twenty-four patients were dialysis-dependent.
  
  
  RESULTS
  The 100-day and the 6, and 12-month treatment-related mortality was 0%. Overall response rate was 92%. The median progression-free survival and overall survival were 1.9 years and 3.8 years, respectively. A multivariate analysis was not performed because of the small sample size. Only 3 patients became dialysis-independent after transplantation. Cardiac, gastrointestinal, genitourinary, infectious, neurologic, and pulmonary "all grade" toxicities were all higher in the melphalan 200 group versus < 200 group, however, none of them were statistically significant.
  
  
  CONCLUSIONS
  Because of a lack of clear survival benefit with higher-dose melphalan and potential higher toxicity in this group, it is reasonable to use lower-dose melphalan in dialysis-dependent myeloma patients.
authors.affiliation: MD Anderson cancer center, Stem Cell Transplant Department, Houston, TX. Electronic address: riadfakih@hotmail.com.
authors.forename: Riad
authors.initials: R
authors.lastname: El Fakih
authors.affiliation: MD Anderson cancer center, Stem Cell Transplant Department, Houston, TX.
authors.forename: Patricia
authors.initials: P
authors.lastname: Fox
authors.affiliation: MD Anderson cancer center, Stem Cell Transplant Department, Houston, TX.
authors.forename: Uday
authors.initials: U
authors.lastname: Popat
authors.affiliation: MD Anderson cancer center, Stem Cell Transplant Department, Houston, TX.
authors.forename: Yago
authors.initials: Y
authors.lastname: Nieto
authors.affiliation: MD Anderson cancer center, Stem Cell Transplant Department, Houston, TX.
authors.forename: Nina
authors.initials: N
authors.lastname: Shah
authors.affiliation: MD Anderson cancer center, Stem Cell Transplant Department, Houston, TX.
authors.forename: Simrit
authors.initials: S
authors.lastname: Parmar
authors.affiliation: MD Anderson cancer center, Stem Cell Transplant Department, Houston, TX.
authors.forename: Betul
authors.initials: B
authors.lastname: Oran
authors.affiliation: MD Anderson cancer center, Stem Cell Transplant Department, Houston, TX.
authors.forename: Stephan
authors.initials: S
authors.lastname: Ciurea
authors.affiliation: MD Anderson cancer center, Stem Cell Transplant Department, Houston, TX.
authors.forename: Partow
authors.initials: P
authors.lastname: Kebriaei
authors.affiliation: MD Anderson cancer center, Stem Cell Transplant Department, Houston, TX.
authors.forename: Chitra
authors.initials: C
authors.lastname: Hosing
authors.affiliation: MD Anderson cancer center, Stem Cell Transplant Department, Houston, TX.
authors.forename: Sairah
authors.initials: S
authors.lastname: Ahmed
authors.affiliation: MD Anderson cancer center, Stem Cell Transplant Department, Houston, TX.
authors.forename: Jatin
authors.initials: J
authors.lastname: Shah
authors.affiliation: MD Anderson cancer center, Stem Cell Transplant Department, Houston, TX.
authors.forename: Robert
authors.initials: R
authors.lastname: Orlowski
authors.affiliation: MD Anderson cancer center, Stem Cell Transplant Department, Houston, TX.
authors.forename: Richard
authors.initials: R
authors.lastname: Champlin
authors.affiliation: MD Anderson cancer center, Stem Cell Transplant Department, Houston, TX.
authors.forename: Muzaffar
authors.initials: M
authors.lastname: Qazilbash
authors.affiliation: MD Anderson cancer center, Stem Cell Transplant Department, Houston, TX.
authors.forename: Qaiser
authors.initials: Q
authors.lastname: Bashir
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000601:surgery* / Q000628:therapy*; D012189:Retrospective Studies; D019172:Transplantation Conditioning / Q000379:methods*; D014182:Transplantation, Autologous / Q000379:methods*
keywords: Autologous stem cell transplant; Melphalan; Mortality; Multiple myeloma; Renal failure