TY - JOUR
T1 - Autologous stem cell transplantation in patients with AL amyloidosis with impaired renal function
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 Q.
AU - Dingli, David
AU - Leung, Nelson
AU - Gonsalves, Wilson I.
AU - Kapoor, Prashant
AU - Kourelis, Taxiarchis V.
AU - Hogan, William J.
AU - Kumar, Shaji K.
AU - Gertz, Morie A.
N1 - Publisher Copyright:
© 2019, Springer Nature Limited.
PY - 2019/11/1
Y1 - 2019/11/1
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/m2 (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.
AB - 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/m2 (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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U2 - 10.1038/s41409-019-0524-2
DO - 10.1038/s41409-019-0524-2
M3 - Article
C2 - 30962503
AN - SCOPUS:85063997276
SN - 0268-3369
VL - 54
SP - 1775
EP - 1779
JO - Bone Marrow Transplantation
JF - Bone Marrow Transplantation
IS - 11
ER -