Auto-HCT Can Be Safe for Myeloma Patients with Renal Insufficiency

In this study, researchers analyzed autologous hematopoietic cell transplantation (HCT) outcomes in 1,492 patients with multiple myeloma (MM) and renal insufficiency (RI). An adjusted multivariate analysis showed no independent impact of RI on 5-year transplant outcomes.

Patients underwent autologous HCT in the U.S. and Canada between 2008 and 2013, and outcomes were reported to CIBMTR® (Center for International Blood and Marrow Transplant Research®). Patients were categorized by Modification of Diet in Renal Disease equation: normal/mild RI (≥60 mL/min, n=1,240), moderate RI (30-59 mL/min, n=185) and severe RI (<30 mL/min, n=67).

Of the 67 patients with severe RI, 35 were on dialysis prior to autologous HCT, and 34 of these 35 patients achieved post-HCT dialysis independence.

The table below shows 5-year outcomes following auto-HCT by RI classification.

 5-year outcome Normal/Mild RI
 Moderate RI
 Severe RI
 Overall survival 68% 68% 60% 0.69
 Progression-free survival 35% 40% 27% 0.42

RI is a common complication to be considered during the assessment of a patients’ eligibility for auto-HCT. Based on this analysis, researchers concluded that “autologous HCT is safe and effective in patients with MM with RI.”

Mahindra A, et al. Bone Marrow Transplant

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