Kidney Week

Abstract: SA-PO183

Impact of Autologous Stem Cell Transplantation on Renal Response in Multiple Myeloma Patients with Advanced Renal Failure

Session Information

• Onco-Nephrology: Clinical
  November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Onco-Nephrology

• 1500 Onco-Nephrology

Authors

• Ryoo, Jiwon, The Catholic University of Korea, Seoul, Korea (the Republic of)

Jiwon Ryoo,

• Kang, Donghyuk, The Catholic University of Korea, Seoul, Korea (the Republic of)

Donghyuk Kang,

• Kwon, Yun Jae, The Catholic University of Korea, Seoul, Korea (the Republic of)

Yun Jae Kwon,

• Kim, Yaeni, The Catholic University of Korea, Seoul, Korea (the Republic of)

Yaeni Kim,

• Kim, Hyung Duk, The Catholic University of Korea, Seoul, Korea (the Republic of)

Hyung Duk Kim,

• Lim, Ji Hee, The Catholic University of Korea, Seoul, Korea (the Republic of)

Ji Hee Lim,

• Kim, Eun Nim, The Catholic University of Korea, Seoul, Korea (the Republic of)

Eun Nim Kim,

• Jin, Yongjie, The Catholic University of Korea, Seoul, Korea (the Republic of)

Yongjie Jin,

• Choi, Bumsoon, The Catholic University of Korea, Seoul, Korea (the Republic of)

Bumsoon Choi,

• Park, Cheol Whee, The Catholic University of Korea, Seoul, Korea (the Republic of)

Cheol Whee Park,

Background

This study aimed to evaluate the impact of autologous stem cell transplantation (ASCT) on renal outcomes of multiple myeloma (MM) patients who had advanced renal failure with estimated glomerular filtration rates (eGFR) ≤60 ml/min/1.73m² at the time point of transplantation.

Methods

In our ASCT database from July 2009 to September 2018, 76 MM patients with median eGFR of 36.6 (range, 5.4-59.8) ml/min/1.73m² at ASCT were included: 47 (61.8%) with eGFR ≥30 and <60ml/min/1.73m²; 16 (21.1%) with eGFR ≥15 and <30ml/min/1.73m²; and 13 (16.9%) with eGFR <15ml/min/1.73m² and/or hemodialysis-dependent. Myeloma and renal response after ASCT were evaluated using the international myeloma working group response criteria.

Results

During median follow-up of 37.3 (range 0.9-108.3) months, transplant-related mortality occurred in seven patients (9.1%). Overall myeloma response was achieved in 70 patients (92.1%): 6 (7.9%) of partial response (PR), 12 (15.8%) of very good partial response (VGPR), and 52 (68.4%) of complete response (CR). Median year-probability of myeloma progression-free survival (PFS) and overall survival were 23.2 (95% CI, 16.9-32.1) and 61.5 (95% CI, 43.6-69.8) months, respectively. Among 20 patients (26.3%) who achieved renal response, including 19 (25.0%) of renal CR and 1 (1.3%) of renal PR, median time to achieve partial response was 267 days (range, 3-2022). In subgroup (n=29) with baseline eGFR <30 ml/min/1.73m², 21 patients (53.8%) achieved renal response after median 53 (3-1756) days post ASCT. In multivariate analysis, IgA type, advanced eGFR (<30 ml/min/1.73m²), and shorter duration from diagnosis to ASCT (<6.6 months) were associated with higher cumulative rate for achieving renal response.

Conclusion

Clinical outcome of myeloma patients after ASCT was favorable. Patients with advanced renal failure may benefit from early ASCT.