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Autologous peripheral blood stem cell transplantation in dialysis‐dependent multiple myeloma patients— DAUTOS Study of the Polish Myeloma Study Group
Author(s) -
WaszczukGajda Anna,
Lewandowski Zbigniew,
DrozdSokołowska Joanna,
Boguradzki Piotr,
Dybko Jarosław,
Wróbel Tomasz,
Basak Grzegorz Władysław,
Jurczyszyn Artur,
Mądry Krzysztof,
Snarski Emilian,
Frączak Ewa,
Charliński Grzegorz,
FeliksbrotBratosiewicz Magdalena,
Król Małgorzata,
MatuszkiewiczRowińska Joanna,
Klinger Marian,
Krajewska Magdalena,
AugustyniakBartosik Hanna,
Kościelska Małgorzata,
Rusicka Patrycja,
DwilewiczTrojaczek Jadwiga,
Wiktor Jędrzejczak Wieslaw
Publication year - 2018
Publication title -
european journal of haematology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 84
eISSN - 1600-0609
pISSN - 0902-4441
DOI - 10.1111/ejh.13101
Subject(s) - medicine , multiple myeloma , dialysis , mucositis , toxicity , propensity score matching , transplantation , gastroenterology , surgery
Dialysis‐dependent ( DD ) multiple myeloma patients ( MM ) have a poor prognosis and high tumour burden, thus may benefit from autologous peripheral blood stem cell transplantation (auto‐ PBSCT ), however, these patients have an increased risk of toxicity. Aims To evaluate the outcomes (toxicity, PFS , OS ) of high dose therapy followed by auto‐ PBSCT during an observational study and after propensity score matching. Patients and methods Between 2004‐2015, 24 DD patients, (aged 38‐67 years), ISS 3, treated with auto‐ PBSCT , requiring dialysis at diagnosis and auto‐ PBSCT were evaluated, matched and compared to 55 normal renal function MM patients ( NRF ) with ISS 3 for outcomes of interest. Results In DD patients compared to NRF patients risk of mucositis (88% vs 55%), infection (79% vs 51%), parenteral nutrition (50% vs 24%), diarrhoea (71% vs 38%), prolonged duration of hospitalisation (medians: 30 vs 21 days), requirement for RBC transfusion (83% vs 36%) were significantly higher, while no significant differences were found in post‐transplant response ( ORR ; 75% vs 87%), 5‐year PFS (36% vs 20%) and OS (39% vs 50%). Subgroup analyses based on toxicity supported these results. Conclusions Despite the increased risk of toxicity in DD patients these events do not significantly affect both the PFS and OS .