Autologous Stem Cells Transplantation for Multiple Myeloma: Improving Chronic Kidney Disease?
16 Pages Posted: 12 Sep 2024
Abstract
Introduction: Chronic Kidney Disease (CKD) often complicates multiple myeloma (MM) and is linked to negative outcomes. Autologous stem cell transplantation (ASCT) has improved MM outcomes, but its safety and effectiveness in CKD patients have been debated. To address this, we conducted a retrospective study of 245 MM patients receiving their initial ASCT and we aim to assess the impact of ASCT on chronic kidney disease.Methods: All symptomatic MM patients who underwent their first ASCT between January 2019 and December 2022 were included in this study.Results: A total of 245 patients with MM were included in the analysis. The median age was 61,4 years (range 30–75). At the time of transplant, 43.7% of patients (n = 107) had an estimated glomerular filtration rate (eGFR) <90 ml/min/1.73 m2. No significant difference in renal function was noted when the median eGFR of the entire cohort was compared between the time of transplant and D + 100 or D + 365 post-transplant. However, in the group of patients with chronic kidney disease at the time of transplantation, when the change in eGFR between D0 and D+100 and D + 365 was compared, a significant improvement in renal function at 1-year post post-transplant was observed (p <0.001 in both). Importantly no significant deterioration in renal function was seen even in patients with moderate or severe CKD and no patients became dialysis dependent post-transplant. Conclusion: These findings support ASCT as a safe and effective treatment for myeloma patients with CKD, including those on dialysis.
Note:
Funding Information: This work has not received any contribution, grant or scholarship.
Conflict of Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Ethical Approval: Informed consent was obtained. Informed consent was obtained and the study complied with the ethical requirements of the Portuguese Oncology Institute of Porto for retrospective observational studies. The authors declare that the procedures followed were followed by the regulations of the clinical research ethics committee and with those of the Code of Ethics of the World Medical Association (Declaration of Helsinki as revised in 2013).
Keywords: autologous stem cell transplantation, chronic kidney disease, hemodialysis, multiple myeloma, outcomes
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