scholarly journals Late recovery of renal failure after autologous haematopoietic stem cell transplantation for multiple myeloma: a report of two cases

2009 ◽  
Vol 2 (3) ◽  
pp. 242-245 ◽  
Author(s):  
N. Bige ◽  
B. Guery ◽  
R. Delarue ◽  
L.-H. Noel ◽  
F. Fakhouri
Keyword(s):  
Multiple Myeloma ◽  
Renal Failure ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Haematopoietic Stem Cell Transplantation ◽  
Haematopoietic Stem Cell ◽  
Late Recovery

scholarly journals Autologous haematopoietic stem cell transplantation in patients with multiple myeloma complicated by dialysis-dependent renal failure

2020 ◽  
Vol 92 (7) ◽  
pp. 70-76
Author(s):  
M. V. Firsova ◽  
L. P. Mendeleeva ◽  
M. V. Solovev ◽  
I. G. Rekhtina ◽  
O. S. Pokrovskaya ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Renal Failure ◽  
Stem Cell ◽  
Partial Response ◽  
Stem Cell Transplantation ◽  
Haematopoietic Stem Cell Transplantation ◽  
Complete Response ◽  
Haematopoietic Stem Cell ◽  
Renal Response ◽  
Good Partial Response

Aim.To assess the safety and efficacy of autologous haematopoietic stem cell transplantation (auto-HSCT) in multiple myeloma (MM) patients with dialysis-dependent renal failure. Materials and methods.During a period from May 2010 to December 2016 fourteen MM patients with dialysis-dependent renal failure aged 48 to 65 years underwent auto-HSCT. After the induction therapy complete response, very good partial response, partial response were documented in 64, 29, 7% of patients, respectively. In no case was a renal response achieved. Haematopoietic stem cell mobilization in most patients (13/14) was performed according to the scheme: G-CSF 10 g/kg. Melphalan in 3 dosages was used as pre-transplant conditioning: 100, 140 and 200 mg/m2; 13 patients underwent a single and in one case underwent a tandem auto-HSCT against the background of hemodialysis. Evaluation of the antitumor and renal response was assessed on the 100th day after auto-HSCT. Subsequently, against the background of programmed hemodialysis and in the setting of high-dosed melphalan (100200 mg/m2), 13 patients underwent a single and one patient underwent a tandem auto-HSCT. At +100 days after auto-HSCT, an antitumor response and renal response were assessed. Results.The period of agranulocytosis after auto-HSCT was from 5 to 12 days (median 8,5) and was accompanied by infectious complications, cardiac and neurological dysfunctions. At +100 days after auto-HSCT, the complete response was confirmed in 71% patients and very good partial response was confirmed in 29% patients. The minimal renal response was registered in 2 patients (14%), hemodialysis was stopped. The transplant-related mortality was absent. After a median follow-up of 53 months 5-year progression-free survival was 59%, and overall survival was 93%. Conclusion.Carrying out auto-HSCT in patients with dialysis-dependent renal failure contributed to the achievement of a minimal renal response in 14% of cases, which allowed these patients to stop hemodialysis. Patients whose conditioning regimen was performed using melphalan at a dose of 200 mg/m2showed more frequent complications in the early post-transplant period compared to patients who received a lower dose of melphalan (100140 mg/m2). Auto-HSCT in MM patients with dialysis-dependent renal failure is a feasible and effective treatment method, which in some cases contributes to independence from hemodialysis.

Donor cell origin of multiple myeloma occurring after allogeneic haematopoietic stem cell transplantation in a patient with refractory anaemia with ring sideroblast

2010 ◽  
Vol 64 (3) ◽  
pp. 265-268 ◽  
Author(s):  
Young-Il Kim ◽  
Hye-Ran Kim ◽  
Myung-Geun Shin ◽  
Young-Jin Lee ◽  
Jong-Hee Shin ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Haematopoietic Stem Cell Transplantation ◽  
Plasma Cells ◽  
Donor Cell ◽  
Haematopoietic Stem Cell ◽  
Solid Organ ◽  
Refractory Anaemia

Post-transplant lymphoproliferative disorder (PTLD) is a rare but life-threatening complication after solid organ and haematopoietic stem cell transplantation. A 40-year-old woman who was diagnosed as having refractory anaemia with ring sideroblast 6 years ago took an ABO mismatched, unrelated allogeneic haematopoietic stem cell transplantation (HSCT) from a 32-year-old healthy male donor. The bone marrow (BM) study was carried out because of progressing pancytopenia, serum biclonal gammopathy and a distorted ratio of serum level of free κ and λ light chain 138 days after HSCT. The BM examination showed an increased number of plasma cells (12% of total marrow cells) comprising mainly CD45−CD19−CD138+ malignant plasma cells with an immunoglobulin heavy-chain gene rearrangement. Conventional cytogenetics and molecular personal identification studies revealed that all BM cells were totally replaced by donor cells, thus indicating the donor cell origin of PTLD-multiple myeloma. The BM microenvironment of the recipient might be associated with the development of PTLD-multiple myeloma.

scholarly journals Yellow nail syndrome after allogeneic haematopoietic stem cell transplantation in two patients with multiple myeloma

2016 ◽  
Vol 71 (6) ◽  
pp. 428-430 ◽  
Author(s):  
Céline Gregoire ◽  
Julien Guiot ◽  
Gaëlle Vertenoeil ◽  
Évelyne Willems ◽  
Kaoutar Hafraoui ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Haematopoietic Stem Cell Transplantation ◽  
Haematopoietic Stem Cell ◽  
Yellow Nail Syndrome

scholarly journals Early and late relapses of multiple myeloma after autologous haematopoietic stem cell transplantation

2021 ◽  
Vol 66 (4) ◽  
pp. 512-525
Author(s):  
E. A. Mamaeva ◽  
L. P. Mendeleeva ◽  
M. V. Solovyev ◽  
M. V. Firsova ◽  
A. A. Kraizman ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Haematopoietic Stem Cell Transplantation ◽  
Haematopoietic Stem Cell ◽  
Late Relapse ◽  
Early Relapse ◽  
Antitumour Response

Introduction. Autologous haematopoietic stem cell transplantation (auto-HSCT) is a highly effective treatment for multiple myeloma (MM). Auto-HSCT allows a signifi cant improvement of haematological response leading to higher overall survival and quality of life in MM patients. Nonetheless, the majority of patients develop relapse.Aim — a comparison of clinical MM relapses developing at variant terms after auto-HSCT.Patients and methods. A retrospective study enrolled 65 MM patients aged between 39 and 64 years. All patients had auto-HSCT during 2009–2019, all had achieved complete response (CR) or very good partial response (VGPR) and all since developed immunochemical MM relapse in laboratory evidence. Patients were divided in two cohorts by relapse term, the early (within 12 months of auto-HSCT) and late relapse.Results. Early immunochemical relapse was diagnosed in 13 (20 %), late relapse — in 52 (80 %) patients. The dependence between relapse term and depth of post-auto-HSCT antitumour response has been determined. The proportion of CR patients was signifi cantly higher in late than in early relapse (55.8 vs. 23 %). In follow-up, 60 patients (92.3 %) were initiated on antirelapse therapy, all early relapse and 90.3 % late relapse patients. On day +100 of auto-HSCT, CR patients had later relapse vs. VGPR individuals (median 24 vs. 19.9 months, p = 0.08) with signifi cantly weaker paraprotein secretion resembling the clinical course of monoclonal gammopathy of unclear signifi cance (MGUS).Conclusion. Auto-HSCT allows long-term control of the disease. A signifi cant prognostic factor is antitumour response on +100 day of auto-HSCT. Patients attaining CR have later relapse progressing in a MGUS-like manner. Patients with late indolent relapse can be managed long-term without antitumour therapy.

scholarly journals The Glasgow Prognostic Score at Diagnosis Is a Predictor of Clinical Outcome in Patients with Multiple Myeloma Undergoing Autologous Haematopoietic Stem Cell Transplantation

Cancers ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 921 ◽  
Author(s):  
Hanno M. Witte ◽  
Bastian Bonorden ◽  
Armin Riecke ◽  
Harald Biersack ◽  
Konrad Steinestel ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Haematopoietic Stem Cell Transplantation ◽  
Independent Predictor ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Haematopoietic Stem Cell ◽  
The Glasgow Prognostic Score

Background: Immunity and inflammatory response affect the tumour microenvironment and the progression of malignancies. Metabolic and inflammatory parameters and ratios of the peripheral blood correlate with outcome in cancer patients. There exist several established and validated inflammation-based scores of prognostic significances including the Glasgow Prognostic Score (GPS). Methods: In this retrospective, multicentre study, we investigated the prognostic capabilities of baseline GPS in patients with multiple myeloma (MM) undergoing autologous stem cell transplantation as a complementary resource for risk stratification. For GPS calculation, a C-reactive-protein (CRP) value of >10 mg/dL counts as one point and an albumin value of <35 g/L connotes another point, resulting in three different subgroups (group I: 0 points; group II: 1 point; and group III: 2 points). Patients with MM admitted to the participating institutions between January 2010 and July 2018 were screened, and established prognostic scores and ratios were assessed. Characteristics significantly associated with overall survival (OS) or progression-free survival (PFS), upon univariate analysis, were included in a Cox proportional hazards model. Results: Following initial assessment, we identified 224 fully evaluable patients who underwent autologous haematopoietic stem cell transplantation for multiple myeloma. A centralised review of pathology and cytogenetic reports was conducted, and a central hematopathology assessment was performed in 175 of 224 cases (78.1%). Proceeding to high-dose chemotherapy and subsequent autologous stem cell transplantation was the main inclusion criterion for all transplant-eligible patients in the study. The median age at diagnosis was 59 years (range: 35–76 years) with a median follow-up of 76 months. Multivariate analysis revealed neutrophil–platelet score (NPS) (HR = 0.528, 95% CI = 0.284–0.984) and B symptoms at primary diagnosis (HR = 1.838, 95% CI = 1.232–2.740) to be independent predictors of PFS while high-risk cytogenetic changes (HR = 2.358, 95% CI = 1.413–3.934, p = 0.001) could be identified as an independent predictor of OS, and GPS to be the only independent predictor of both OS and PFS (OS: HR = 2.127, 95% CI = 1.431–3.162, p < 0.0001 and PFS: HR = 1.405; 95% CI = 1.058–1.867, p = 0.019). Conclusions: Our data show that baseline GPS correlates with rates of relapse and refractory disease in MM patients undergoing autologous transplantation. In a multivariate analysis, these effects were proven to hold prognostic capabilities beyond and independent from established prognosticators. These results require further validation in a prospective setting.

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