Autologous Hematopoietic Stem Cell Transplantation in Dialysis-Dependent Myeloma Patients

Riad El Fakih; Patricia Fox; Uday Popat; Yago Nieto; Nina Shah; Simrit Parmar; Betul Oran; Stephan Ciurea; Partow Kebriaei; Chitra Hosing; Sairah Ahmed; Jatin Shah; Robert Orlowski; Richard Champlin; Muzaffar Qazilbash; Qaiser Bashir

doi:10.1016/j.clml.2015.03.003

Autologous Hematopoietic Stem Cell Transplantation in Dialysis-Dependent Myeloma Patients

Riad El Fakih, Patricia Fox, Uday Popat, Yago Nieto, Nina Shah, Simrit Parmar, Betul Oran, Stephan Ciurea, Partow Kebriaei, Chitra Hosing, Sairah Ahmed, Jatin Shah, Robert Orlowski, Richard Champlin, Muzaffar Qazilbash, Qaiser Bashir

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24 Scopus citations

Abstract

Abstract Background We retrospectively analyzed our transplant database from July 2000 to June 2012 to identify myeloma patients who received autologous stem cell transplantation while dialysis-dependent. Patients 2091 patients underwent autologous high-dose therapy during this period. Twenty-four patients were dialysis-dependent. Results The 100-day and the 6, and 12-month treatment-related mortality was 0%. Overall response rate was 92%. The median progression-free survival and overall survival were 1.9 years and 3.8 years, respectively. A multivariate analysis was not performed because of the small sample size. Only 3 patients became dialysis-independent after transplantation. Cardiac, gastrointestinal, genitourinary, infectious, neurologic, and pulmonary "all grade" toxicities were all higher in the melphalan 200 group versus < 200 group, however, none of them were statistically significant. Conclusion Because of a lack of clear survival benefit with higher-dose melphalan and potential higher toxicity in this group, it is reasonable to use lower-dose melphalan in dialysis-dependent myeloma patients.

Original language	English (US)
Article number	577
Pages (from-to)	472-476
Number of pages	5
Journal	Clinical Lymphoma, Myeloma and Leukemia
Volume	15
Issue number	8
DOIs	https://doi.org/10.1016/j.clml.2015.03.003
State	Published - Aug 1 2015

Keywords

Autologous stem cell transplant
Melphalan
Mortality
Multiple myeloma
Renal failure

ASJC Scopus subject areas

Hematology
Oncology
Cancer Research

MD Anderson CCSG core facilities

Clinical Trials Office

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10.1016/j.clml.2015.03.003

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El Fakih, R., Fox, P., Popat, U., Nieto, Y., Shah, N., Parmar, S., Oran, B., Ciurea, S., Kebriaei, P., Hosing, C., Ahmed, S., Shah, J., Orlowski, R., Champlin, R., Qazilbash, M., & Bashir, Q. (2015). Autologous Hematopoietic Stem Cell Transplantation in Dialysis-Dependent Myeloma Patients. Clinical Lymphoma, Myeloma and Leukemia, 15(8), 472-476. Article 577. https://doi.org/10.1016/j.clml.2015.03.003

El Fakih, R, Fox, P, Popat, U , Nieto, Y, Shah, N, Parmar, S , Oran, B, Ciurea, S, Kebriaei, P , Hosing, C , Ahmed, S, Shah, J, Orlowski, R , Champlin, R , Qazilbash, M & Bashir, Q 2015, 'Autologous Hematopoietic Stem Cell Transplantation in Dialysis-Dependent Myeloma Patients', Clinical Lymphoma, Myeloma and Leukemia, vol. 15, no. 8, 577, pp. 472-476. https://doi.org/10.1016/j.clml.2015.03.003

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abstract = "Abstract Background We retrospectively analyzed our transplant database from July 2000 to June 2012 to identify myeloma patients who received autologous stem cell transplantation while dialysis-dependent. Patients 2091 patients underwent autologous high-dose therapy during this period. Twenty-four patients were dialysis-dependent. Results The 100-day and the 6, and 12-month treatment-related mortality was 0%. Overall response rate was 92%. The median progression-free survival and overall survival were 1.9 years and 3.8 years, respectively. A multivariate analysis was not performed because of the small sample size. Only 3 patients became dialysis-independent after transplantation. Cardiac, gastrointestinal, genitourinary, infectious, neurologic, and pulmonary {"}all grade{"} toxicities were all higher in the melphalan 200 group versus < 200 group, however, none of them were statistically significant. Conclusion Because of a lack of clear survival benefit with higher-dose melphalan and potential higher toxicity in this group, it is reasonable to use lower-dose melphalan in dialysis-dependent myeloma patients.",

keywords = "Autologous stem cell transplant, Melphalan, Mortality, Multiple myeloma, Renal failure",

author = "{El Fakih}, Riad and Patricia Fox and Uday Popat and Yago Nieto and Nina Shah and Simrit Parmar and Betul Oran and Stephan Ciurea and Partow Kebriaei and Chitra Hosing and Sairah Ahmed and Jatin Shah and Robert Orlowski and Richard Champlin and Muzaffar Qazilbash and Qaiser Bashir",

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doi = "10.1016/j.clml.2015.03.003",

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T1 - Autologous Hematopoietic Stem Cell Transplantation in Dialysis-Dependent Myeloma Patients

AU - El Fakih, Riad

AU - Fox, Patricia

AU - Popat, Uday

AU - Nieto, Yago

AU - Shah, Nina

AU - Parmar, Simrit

AU - Oran, Betul

AU - Ciurea, Stephan

AU - Kebriaei, Partow

AU - Hosing, Chitra

AU - Ahmed, Sairah

AU - Shah, Jatin

AU - Orlowski, Robert

AU - Champlin, Richard

AU - Qazilbash, Muzaffar

AU - Bashir, Qaiser

PY - 2015/8/1

Y1 - 2015/8/1

N2 - Abstract Background We retrospectively analyzed our transplant database from July 2000 to June 2012 to identify myeloma patients who received autologous stem cell transplantation while dialysis-dependent. Patients 2091 patients underwent autologous high-dose therapy during this period. Twenty-four patients were dialysis-dependent. Results The 100-day and the 6, and 12-month treatment-related mortality was 0%. Overall response rate was 92%. The median progression-free survival and overall survival were 1.9 years and 3.8 years, respectively. A multivariate analysis was not performed because of the small sample size. Only 3 patients became dialysis-independent after transplantation. Cardiac, gastrointestinal, genitourinary, infectious, neurologic, and pulmonary "all grade" toxicities were all higher in the melphalan 200 group versus < 200 group, however, none of them were statistically significant. Conclusion Because of a lack of clear survival benefit with higher-dose melphalan and potential higher toxicity in this group, it is reasonable to use lower-dose melphalan in dialysis-dependent myeloma patients.

AB - Abstract Background We retrospectively analyzed our transplant database from July 2000 to June 2012 to identify myeloma patients who received autologous stem cell transplantation while dialysis-dependent. Patients 2091 patients underwent autologous high-dose therapy during this period. Twenty-four patients were dialysis-dependent. Results The 100-day and the 6, and 12-month treatment-related mortality was 0%. Overall response rate was 92%. The median progression-free survival and overall survival were 1.9 years and 3.8 years, respectively. A multivariate analysis was not performed because of the small sample size. Only 3 patients became dialysis-independent after transplantation. Cardiac, gastrointestinal, genitourinary, infectious, neurologic, and pulmonary "all grade" toxicities were all higher in the melphalan 200 group versus < 200 group, however, none of them were statistically significant. Conclusion Because of a lack of clear survival benefit with higher-dose melphalan and potential higher toxicity in this group, it is reasonable to use lower-dose melphalan in dialysis-dependent myeloma patients.

KW - Autologous stem cell transplant

KW - Melphalan

KW - Mortality

KW - Multiple myeloma

KW - Renal failure

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Autologous Hematopoietic Stem Cell Transplantation in Dialysis-Dependent Myeloma Patients

Abstract

Keywords

ASJC Scopus subject areas

MD Anderson CCSG core facilities

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