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Lower glomerular filtration rate predicts increased hepatic and mucosal toxicity in myeloma patients treated with high-dose melphalan.

Abstract：

:High-dose melphalan followed by autologous hematopoietic stem cell transplantation (ASCT) is a standard treatment for younger myeloma patients. However, the correlation between its toxicity and renal impairment is not clear. We analyzed this relationship, focusing on estimated glomerular filtration rate (eGFR) as an index of renal function. We evaluated 78 multiple myeloma patients who underwent ASCT following high-dose melphalan at our center. Patients were divided into a higher eGFR group (eGFR ≥ 60) and a lower eGFR group (eGFR < 60). Multivariate analyses revealed that lower eGFR was independently associated with alkaline phosphatase elevation (OR 10.2, P = 0.038), mucositis (OR 10.5, P = 0.032), grade 2-4 co-elevation of both aspartate aminotransferase and alanine aminotransferase (OR 21.3, P = 0.016), delay of reticulocyte engraftment (HR 0.524, P = 0.034), and delay of platelet engraftment (HR 0.535, P = 0.0016). However, lower eGFR was not correlated with overall survival or time-to-next treatment. In summary, renal dysfunction secondary to administration of high-dose melphalan was associated with increased hepatic and mucosal toxicity and delay of hematological recovery, but did not affect survival outcomes.

journal_name

Int J Hematol

journal_title

International journal of hematology

authors

Tamaki M,Nakasone H,Gomyo A,Hayakawa J,Akahoshi Y,Harada N,Kusuda M,Ishihara Y,Kawamura K,Tanihara A,Sato M,Terasako-Saito K,Kameda K,Wada H,Kikuchi M,Kimura SI,Kako S,Kanda Y

doi

10.1007/s12185-018-2507-2

subject

Has Abstract

pub_date

2018-10-01 00:00:00

pages

423-431

issue

4

eissn

0925-5710

issn

1865-3774

pii

10.1007/s12185-018-2507-2

journal_volume

108

pub_type

临床试验,杂志文章

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