Autologous stem cell transplantation in patients with AL amyloidosis with impaired renal function

M. Hasib Sidiqi, Kalyan Nadiminti, Abdullah S. Al Saleh, Kapil Meleveedu, Francis K. Buadi, Angela Dispenzieri, Rahma Warsame, Martha Lacy, David M Dingli, Nelson Leung, Wilson Gonsalves, Prashant Kapoor, Taxiarchis Kourelis, William Hogan, Shaji K Kumar, Morie Gertz

Research output: Contribution to journalArticle

Abstract

We retrospectively reviewed the impact of impaired renal function (eGFR < 45 ml/min/SA) on post-transplant outcomes in patients receiving ASCT for AL amyloidosis. Patients were grouped into two cohorts, those with normal renal function (NRF) eGFR ≥ 45 ml/min (n = 568) and those with impaired renal function (IRF) eGFR < 45 ml/min (n = 87). Patients with IRF had higher renal stage (>Stage 1: 100% IRF vs 37% NRF, p < 0.0001) and the majority received conditioning with melphalan <200 mg/m 2 (70% IRF vs 21% NRF, p < 0.0001). Forty-four patients (6.7%) required dialysis within 100 days of ASCT. Renal stage predicted for dialysis institution within 100 days of ASCT (3% Stage I vs 10% Stage II vs 22% Stage III, p < 0.0001). Dialysis within 100 days was higher in the IRF cohort (16% for IRF cohort vs 6% for NRF cohort, p = 0.0007. Patients with impaired renal function were more likely to be admitted to hospital (80% IRF vs 70% NRF, p = 0.03). The 100-day mortality was higher in the IRF cohort (14% IRF cohort vs 5% NRF cohort, p = 0.008). Median OS and PFS were similar between the two cohorts. Impaired renal function predicts for a higher rate of hospitalization, progression to dialysis and early mortality in patients receiving ASCT for AL amyloidosis.

Original languageEnglish (US)
JournalBone Marrow Transplantation
DOIs
StatePublished - Jan 1 2019

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Stem Cell Transplantation
Amyloidosis
Dialysis
Kidney
Melphalan
Mortality
Hospitalization

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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Autologous stem cell transplantation in patients with AL amyloidosis with impaired renal function. / Sidiqi, M. Hasib; Nadiminti, Kalyan; Al Saleh, Abdullah S.; Meleveedu, Kapil; Buadi, Francis K.; Dispenzieri, Angela; Warsame, Rahma; Lacy, Martha; Dingli, David M; Leung, Nelson; Gonsalves, Wilson; Kapoor, Prashant; Kourelis, Taxiarchis; Hogan, William; Kumar, Shaji K; Gertz, Morie.

In: Bone Marrow Transplantation, 01.01.2019.

Research output: Contribution to journalArticle

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abstract = "We retrospectively reviewed the impact of impaired renal function (eGFR < 45 ml/min/SA) on post-transplant outcomes in patients receiving ASCT for AL amyloidosis. Patients were grouped into two cohorts, those with normal renal function (NRF) eGFR ≥ 45 ml/min (n = 568) and those with impaired renal function (IRF) eGFR < 45 ml/min (n = 87). Patients with IRF had higher renal stage (>Stage 1: 100{\%} IRF vs 37{\%} NRF, p < 0.0001) and the majority received conditioning with melphalan <200 mg/m 2 (70{\%} IRF vs 21{\%} NRF, p < 0.0001). Forty-four patients (6.7{\%}) required dialysis within 100 days of ASCT. Renal stage predicted for dialysis institution within 100 days of ASCT (3{\%} Stage I vs 10{\%} Stage II vs 22{\%} Stage III, p < 0.0001). Dialysis within 100 days was higher in the IRF cohort (16{\%} for IRF cohort vs 6{\%} for NRF cohort, p = 0.0007. Patients with impaired renal function were more likely to be admitted to hospital (80{\%} IRF vs 70{\%} NRF, p = 0.03). The 100-day mortality was higher in the IRF cohort (14{\%} IRF cohort vs 5{\%} NRF cohort, p = 0.008). Median OS and PFS were similar between the two cohorts. Impaired renal function predicts for a higher rate of hospitalization, progression to dialysis and early mortality in patients receiving ASCT for AL amyloidosis.",
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AU - Sidiqi, M. Hasib

AU - Nadiminti, Kalyan

AU - Al Saleh, Abdullah S.

AU - Meleveedu, Kapil

AU - Buadi, Francis K.

AU - Dispenzieri, Angela

AU - Warsame, Rahma

AU - Lacy, Martha

AU - Dingli, David M

AU - Leung, Nelson

AU - Gonsalves, Wilson

AU - Kapoor, Prashant

AU - Kourelis, Taxiarchis

AU - Hogan, William

AU - Kumar, Shaji K

AU - Gertz, Morie

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N2 - We retrospectively reviewed the impact of impaired renal function (eGFR < 45 ml/min/SA) on post-transplant outcomes in patients receiving ASCT for AL amyloidosis. Patients were grouped into two cohorts, those with normal renal function (NRF) eGFR ≥ 45 ml/min (n = 568) and those with impaired renal function (IRF) eGFR < 45 ml/min (n = 87). Patients with IRF had higher renal stage (>Stage 1: 100% IRF vs 37% NRF, p < 0.0001) and the majority received conditioning with melphalan <200 mg/m 2 (70% IRF vs 21% NRF, p < 0.0001). Forty-four patients (6.7%) required dialysis within 100 days of ASCT. Renal stage predicted for dialysis institution within 100 days of ASCT (3% Stage I vs 10% Stage II vs 22% Stage III, p < 0.0001). Dialysis within 100 days was higher in the IRF cohort (16% for IRF cohort vs 6% for NRF cohort, p = 0.0007. Patients with impaired renal function were more likely to be admitted to hospital (80% IRF vs 70% NRF, p = 0.03). The 100-day mortality was higher in the IRF cohort (14% IRF cohort vs 5% NRF cohort, p = 0.008). Median OS and PFS were similar between the two cohorts. Impaired renal function predicts for a higher rate of hospitalization, progression to dialysis and early mortality in patients receiving ASCT for AL amyloidosis.

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