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

Table 3

ASCT in myeloma patients with renal insufficiency: the retrospective analysis studies.

Author

Country

No.

Median age

Diagnosis of RF

Conditioning regimen

Clinical response and survival (%)

Response of renal function in the RF group

CR

PR

VGPR

OS

EFS

PFS

TRM

Badros et al. [32]

USA

81

53

Mel140 (26%); Mel200 (74%)

58

NR

NR

55

48

NR

6

NR

Augeul-Meunier et al. [30]

France

55

61

Mel140 (87%); Mel200 (13%)

43

96

58

72

NR

45

6

10 patients (18%) presented minor renal response and 1 with partial renal response; Proteinuria decreased for the majority of patients (60%)

Ballester et al. [34]

USA

6

50

BUCY

17

50

NR

50

NR

NR

50

1 patient (17%) has shown a progressive recovery of renal function (SCr was decreased)

Balsam et al. [35]

USA

192

57.1

GFR

Conventional chemotherapy

NR

NR

NR

NR

NR

NR

NR

64 patients (33%) reversed renal failure (GFR was increased)

Bernard et al. [18]

Canada

33

56

NR

Mel 140 (36%); Mel 160 (3%); Mel 200 (61%)

50

46

50

63

NR

NR

15

7 patients (25%) had an improved renal function

Glavey et al. [36]

USA

30

61

NR

NR

NR

NR

NR

NR

NR

NR

Average creatinine 4.9 mg/dl decreased to 3.9 mg/dl

Seuk Hui et al. [47]

Korea

41

49

eGFR (MDRD)

Mel 100 (100%)

NR

NR

NR

NR

NR

NR

NR

Average eGFR decreased in 24 months

Parikh et al. [33]

USA

46

56

Mel 140 (6%); Mel 180 (29%); Mel 200 (65%)

22

53

NR

64

NR

36

NR

15 patients (32%) experienced a sustained improvement in renal function (eGFR was increased); 10 patients (21%) experienced a downstaging of renal failure

Tosi et al. [31]

Italy

6

47

Mel 80 (83%)

0

67

0

NR

NR

NR

NR

5 patient (83%) have shown increased CrCl

ASCT: autologous stem cell transplantation; BUCY: Busulfan and Toxicity cyclophosphamide; RF: renal failure; Mel: melphalan; CrCl: creatinine clearance; SCr: serum creatinine; GFR: glomerular filtration rate; eGFR: estimated glomerular filtration rate; 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.