Long-term outcome of patients with multiple [corrected] myeloma-related advanced renal failure following auto-SCT

Area of Science:

• Nephrology
• Hematology
• Oncology

Background:

• Renal failure is a common and serious complication of multiple myeloma (MM).
• The impact of autologous stem cell transplant (auto-SCT) on renal outcomes in MM patients with advanced kidney impairment remains unclear.
• This study investigates the effect of auto-SCT on renal function and dialysis dependence in MM patients with severe renal failure.

Purpose of the Study:

• To assess the association between auto-SCT and renal outcomes in MM patients with advanced renal failure (serum creatinine >3 mg/dL).
• To evaluate the potential for auto-SCT to improve kidney function or achieve independence from dialysis in this patient group.

Main Methods:

• Retrospective cohort study of MM patients with advanced renal failure who underwent auto-SCT between 2000 and 2010.
• Inclusion criteria: serum creatinine >3 mg/dL attributable to MM, including dialysis-dependent patients.
• Analysis of renal function (GFR) and dialysis status pre- and post-auto-SCT, considering hematologic response (HR).

Main Results:

• Fourteen of fifteen dialysis-dependent patients remained dialysis-dependent post-auto-SCT, irrespective of hematologic response.
• In patients with serum creatinine >3 mg/dL not requiring dialysis, a statistically significant improvement in GFR was observed (15 to 19.4 mL/min/1.73 m²; P=0.035).
• Neither hematologic response nor pre-existing renal function independently predicted renal outcomes post-auto-SCT.

Conclusions:

• Autologous stem cell transplant is not associated with achieving independence from dialysis in multiple myeloma patients with renal failure.
• While auto-SCT may lead to a modest improvement in GFR in some MM patients with severe renal impairment, this effect is not clearly linked to hematologic response.