scholarly journals Treosulfan conditioning for allogeneic transplantation in multiple myeloma – improved overall survival in first line haematopoietic stem cell transplantation – a large retrospective study by the Chronic Malignancies Working Party of the EBMT

2020 ◽  
Vol 189 (5) ◽  
Author(s):  
Charlotte Gran ◽  
Junfeng Wang ◽  
Hareth Nahi ◽  
Linda Koster ◽  
Gösta Gahrton ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Overall Survival ◽  
Stem Cell ◽  
Retrospective Study ◽  
Haematopoietic Stem Cell Transplantation ◽  
Working Party ◽  
Allogeneic Transplantation ◽  
Haematopoietic Stem Cell ◽  
First Line ◽  
Large Retrospective Study

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.

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