Safety and efficacy of autologous stem cell transplantation in dialysis-dependent myeloma patients-The DIADEM study from the chronic malignancies working party of the EBMT

被引：5

作者：

Waszczuk-Gajda, Anna ^{[1
]}

Gras, Luuk ^{[2
]}

de Wreede, Liesbeth C. ^{[3
]}

Sirait, Tiarlan ^{[4
]}

Illes, Arpad ^{[5
]}

Ozkurt, Zubeyde Nur ^{[6
]}

Snowden, John A. ^{[7
]}

Arat, Mutlu ^{[8
]}

Bulabois, Claude Eric ^{[9
]}

Niederland, Judith ^{[10
]}

Sever, Matjaz ^{[11
]}

Paneesha, Shankara ^{[12
]}

Potter, Victoria ^{[13
]}

Gadisseur, Alain ^{[14
]}

Chalopin, Thomas ^{[15
]}

Van Gorkom, Gwendolyn ^{[16
]}

Lopez, Joaquin Martinez ^{[17
]}

Kerre, Tessa ^{[18
]}

Drozd-Sokolowska, Joanna ^{[1
]}

Raj, Kavita ^{[19
]}

Hayden, Patrick J. ^{[20
]}

Beksac, Meral ^{[21
]}

Yakoub-Agha, Ibrahim ^{[22
]}

McLornan, Donal P. ^{[19
]}

Schoenland, Stefan ^{[23
]}

机构：

[1] Med Univ Warsaw, Univ Clin Ctr, Warsaw, Poland

[2] EBMT Stat Unit, Leiden, Netherlands

[3] Leiden Univ, Med Ctr, Dept Biomed Data Sci, Leiden, Netherlands

[4] EBMT Leiden Study Unit, Leiden, Netherlands

[5] Univ Debrecen, Fac Med, Debrecen, Hungary

[6] Gazi Univ, Fac Med, Dept Hematol, Ankara, Turkiye

[7] Sheffield Teaching Hosp NHS Fdn Trust, Sheffield, England

[8] Demiroglu Bilim Univ, Istanbul Florence Nightingale Hosp, Istanbul, Turkiye

[9] Univ Grenoble Alpes, CHU Grenoble Alpes, Grenoble, France

[10] HELIOS Klinikum Berlin Buch, Judith Niederland, Berlin, Germany

[11] Univ Ljubljana, Univ Med Ctr, Slovenia Fac Med, Ljubljana, Slovenia

[12] Univ Hosp Birmingham NHS Fdn Trust, Dept Haematol, Birmingham, England

[13] Kings Coll Hosp London, London, England

[14] Antwerp Univ Hosp UZA, Alain Gadisseur, Antwerp, Belgium

[15] Hop Bretonneau, Tours, France

[16] Maastricht Univ, GROW Sch Oncol & Dev Biol, Dept Internal Med, Div Hematol,Med Ctr, NL-6229 HX Maastricht, Netherlands

[17] Hosp Univ 12 Octubre, Madrid, Spain

[18] Ghent Univ Hosp, Ghent, Belgium

[19] Univ Coll London Hosp NHS Trust, London, England

[20] Trinity Coll Dublin, Sch Med, Dept Haematol, Dublin, Ireland

[21] Ankara Univ, Fac Med, Ankara, Turkiye

[22] Univ Lille, CHU Lille, INSERM, Infin,U1286, F-59000 Lille, France

[23] Heidelberg Univ, Med Klin Poliklin 5, Heidelberg, Germany

来源：

BONE MARROW TRANSPLANTATION | 2023年 / 58卷 / 04期

关键词：

MULTIPLE-MYELOMA; RENAL-FAILURE; BORTEZOMIB; INSUFFICIENCY; LENALIDOMIDE; MULTICENTER; SCT;

D O I：

10.1038/s41409-023-01915-7

中图分类号：

Q6 [生物物理学];

学科分类号：

071011 ;

摘要：

The role of high-dose chemotherapy followed by autologous stem cell transplantation (ASCT) in the treatment of myeloma (MM) patients with severe and/or dialysis-dependent renal impairment remains uncertain. We report on the outcomes of 110 patients (median age 57 years) who had become dialysis-dependent pre-ASCT and who underwent a first ASCT between 1997 and 2017. Sixty-three (57%) patients had light chain MM. All patients required dialysis (94% hemodialysis and 6% peritoneal). Forty-four of 71 (62%) patients received bortezomib-based induction regimens and 42 (39%) patients had achieved at least a very good partial response (VGPR) pre-ASCT. Melphalan dosing was as follows: <= 140 mg/m(2) (82%), and >140 mg/m(2) (18%). The median PFS after ASCT was 35 months (95% CI: 21.5-42.2) and the median OS 102 months (95% CI: 70.4-129.1). At 1, 2, and 5 years after ASCT, 8% (95% CI 3-14%), 13% (6-20%), and 20% (12-29%) of patients, respectively, had achieved dialysis independence. In multivariate analyses of OS and PFS including age at ASCT, response at ASCT, and year of ASCT, younger age at ASCT and better response at ASCT (CR/VGPR/PR vs. MR/SD/progression) were significantly associated with better OS and PFS.

引用

页码：424 / 429

页数：6

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