Autologous Stem Cell Transplantation in Multiple Myeloma with Renal Failure: Friend or Foe?

Table 2

ASCT in myeloma patients with renal failure, the cohort studies.

Author

Country

No.

Median age

Diagnosis of RF

Conditioning regimen

NRF/RF

Clinical response and survival (NRF/RF) (%)

Response of renal function in RF group

CR

PR

VGPR

OS

EFS

PFS

TRM

Antlanger et al. [29]

Austria

288

57

(MDRD)

Conventional chemotherapy

238/50

41/36

26/17

28/28

70/68

NR

29/27

NR

Creatinine 2.6 mg/ml decreased to 2.0 mg/ml and eGFR 33 increased to 41 ml/min/1.73 m^2

Gertz et al. [28]

USA

677

59

Melphalan (140/200 mg/m^2)

637/40

NR

NR

NR

48/24

NR

NR

NR

NR

Knudsen et al. [16]

Denmark

107

56

9

Melphalan (100/140/200 mg/m^2)

78/29

93/83

93/83

NR

85/52

50/27

NR

1/17

10 patients reached a normal renal function

Mahindra et al. [27]

USA

1307

60

(MDRD)

Melphalan (140/200 mg/m^2)

1240/67

32/34

23/24

30/16

70/60

NR

35/27

25/33

NR

Raab et al. [25]

USA

34

58

Melphalan (100/200 mg/m^2)

17/17

53/59

24/24

NR

70/42

20/18

NR

6/6

NR

San Miguel et al. [26]

Spanish

493

55

Melphalan (140 mg/m^2)

479/14

48/80

43/10

NR

61/56

NR

44/27

3.3/29

6 patients reached levels of creatinine 2 mg/dl and CrCl 50 ml/min

ASCT: autologous stem cell transplantation; RF: renal failure; CrCl: creatinine clearance; SCr: serum creatinine; OS: overall survival; EFS: event-free survival; PFS: processing free survival; CR: complete response; PR: partial response; VGPR: very good partial response; TRM: transplantation related mortality; NR: not reported; MDRD: Modification of Diet in Renal Disease; eGFR: estimated glomerular filtration rate.