J Korean Med Sci.  2011 Oct;26(10):1310-1315. 10.3346/jkms.2011.26.10.1310.

Changes in Renal Function after Different Tandem Hematopoietic Stem-cell Transplantation Approaches in Patients with Multiple Myeloma

• Kang SH
• Hwang HS
• Park HS
• Sun IO
• Choi SR
• Chung BH
• Choi BS
• Yang CW
• Kim YS
• Min CK
• Park CW

• KMID: 1785988
• DOI: http://doi.org/10.3346/jkms.2011.26.10.1310

Abstract

This study was done to observe the alteration of the estimated glomerular filtration rate (eGFR) in multiple myeloma patients according to type of tandem hematopoietic stem cell transplantation (HSCT). Forty-one patients were enrolled in this study. Twenty patients underwent autologous HSCT (auto-HSCT) and 21 patients underwent allogeneic HSCT (allo-HSCT). The changes in eGFR after the two tandem HSCT modalities were different between the two groups, according to the donor of stem cells (P = 0.016). In the auto-HSCT group, the eGFR, recorded 12 months after secondary HSCT, was significantly decreased compared with the eGFR recorded before stem cell mobilization (P = 0.005). Although there was no significant difference, the trend showed that the eGFR after allo-HSCT decreased from the previous HSCT until a month after secondary HSCT. In addition, after 6 months of secondary HSCT, the eGFR recovered to the level recorded prior to the HSCT (P = 0.062). This difference may be due to total body irradiation, a calcineurin inhibitor, or maintemance therapy. Changes in renal function would be monitored closely for these patients. The recovery of the eGFR would be a main focus for the patients treated with the total body irradiation or the calcineurin inhibitor, a progressive decline of the eGFR would be also crucial for the patients treated with maintenance therapy.

Keyword

Multiple Myeloma; Allogeneic Stem-Cell Transplantation; Autologous Stem-Cell Transplantation; Renal Function; Tandem Transplantation

MeSH Terms

Adult
Combined Modality Therapy
Female
*Glomerular Filtration Rate
*Hematopoietic Stem Cell Transplantation
Humans
Kidney/*physiology
Male
Middle Aged
Multiple Myeloma/physiopathology/radiotherapy/*therapy
Transplantation, Autologous
Transplantation, Homologous
Treatment Outcome

Figure

• 

  Fig. 1 Changes in eGFR after the two types of tandem HSCT. SCM, stem-cell mobilization; HSCT, hematopoietic stem-cell transplantation; 1°, 1 month after first hematopoietic stem-cell transplantation; eGFR, estimated glomerular filtration rate; auto-HSCT, autologous tandem hematopoietic stem-cell transplantation; allo-HSCT, autologous/allogeneic tandem hematopoietic stem-cell transplantation.

• 

  Fig. 2 Incidence of chronic kidney disease stage 2 or 3 after the two types of tandem HSCT: before HSCT, 25% for auto-HSCT, 42.9% for allo-HSCT; 6 months after secondary HSCT, 55.0% for auto-HSCT, 76.2% for allo-HSCT; 24 months after secondary, 80.0% for auto-HSCT, 61.9% for allo-HSCT. preHSCT, before hematopoietic stem-cell transplantation, auto-HSCT, autologous tandem hematopoietic stem-cell transplantation; allo-HSCT, autologous/allogeneic tandem hematopoietic stem-cell transplantation.

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