ISSN (print) 1997-6933     ISSN (online) 2500-2139
Vol. 18 No. 2 (2025), BONE MARROW TRANSPLANTATION
Vol. 18 No. 2 (2025)
BONE MARROW TRANSPLANTATION

Autologous Hematopoietic Stem Cell Transplantation in Multiple Myeloma Complicated by Dialysis-Dependent Renal Failure

Published 01.04.2025
Ekaterina Alekseevna Karimova
City Clinical Hospital No. 52, 3 Pekhotnaya ul., Moscow, Russian Federation, 123182
https://orcid.org/0000-0001-7603-1741
E.I. Zhelnova
City Clinical Hospital No. 52, 3 Pekhotnaya ul., Moscow, Russian Federation, 123182; IM Sechenov Sechenov First Moscow State Medical University, 8 korp. 2 Trubetskaya ul., Moscow, Russian Federation, 119991
https://orcid.org/0000-0002-0343-9348
E.A. Baryakh
City Clinical Hospital No. 52, 3 Pekhotnaya ul., Moscow, Russian Federation, 123182; IM Sechenov Sechenov First Moscow State Medical University, 8 korp. 2 Trubetskaya ul., Moscow, Russian Federation, 119991; Russian Medical Academy of Postgraduate Education, 2/1 Barrikadnaya ul., Moscow, Russian Federation, 125993
https://orcid.org/0000-0001-6880-9269
E.Yu. Grishina
City Clinical Hospital No. 52, 3 Pekhotnaya ul., Moscow, Russian Federation, 123182
https://orcid.org/0000-0002-9104-1216
E.N. Zotina
City Clinical Hospital No. 52, 3 Pekhotnaya ul., Moscow, Russian Federation, 123182; IM Sechenov Sechenov First Moscow State Medical University, 8 korp. 2 Trubetskaya ul., Moscow, Russian Federation, 119991
https://orcid.org/0000-0001-9692-2541
D.E. Gagloeva
City Clinical Hospital No. 52, 3 Pekhotnaya ul., Moscow, Russian Federation, 123182; IM Sechenov Sechenov First Moscow State Medical University, 8 korp. 2 Trubetskaya ul., Moscow, Russian Federation, 119991
https://orcid.org/0000-0001-6254-5362
V.N. Yakimets
City Clinical Hospital No. 52, 3 Pekhotnaya ul., Moscow, Russian Federation, 123182
https://orcid.org/0009-0006-4736-0187
O.L. Kochneva
City Clinical Hospital No. 52, 3 Pekhotnaya ul., Moscow, Russian Federation, 123182
https://orcid.org/0000-0003-1338-8203
E.N. Misyurina
City Clinical Hospital No. 52, 3 Pekhotnaya ul., Moscow, Russian Federation, 123182; IM Sechenov Sechenov First Moscow State Medical University, 8 korp. 2 Trubetskaya ul., Moscow, Russian Federation, 119991
https://orcid.org/0000-0003-2419-4850
2025-2
PDF_2025-18-2-171-176 (Russian)

Keywords

multiple myeloma
renal failure
hemodialysis
autologous hematopoietic stem cell transplantation
conditioning regimens

How to Cite

Karimova E.A., Zhelnova E.I., Baryakh E.A., Grishina E.Y., Zotina E.N., Gagloeva D.E., Yakimets V.N., Kochneva O.L., Misyurina E.N. Autologous Hematopoietic Stem Cell Transplantation in Multiple Myeloma Complicated by Dialysis-Dependent Renal Failure. Clinical Oncohematology. 2025;(2):171–176. doi:10.21320/2500-2139-2025-18-2-171-176.
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Abstract

BACKGROUND. Renal failures, among them dialysis-dependent kidney disease, are common complications of multiple myeloma (ММ). Hemodialysis (HD) independence is achieved in only 20 % of standard induction therapy recipients. The survival of program HD patients remains unsatisfactory. Autologous hematopoietic stem cell transplantation (auto-HSCT) is usually planned and performed in young MM patients. However, the program HD patients are often excluded from the high-dose chemotherapy protocols with subsequent auto-HSCT due to the therapy associated toxicity risk.

AIM. To assess the efficacy and safety of auto-HSCT in MM complicated by dialysis-dependent renal failure.

MATERIALS & METHODS. In the period from 2015 to 2022, 14 program HD patients (8 men and 6 women) received auto-HSCT at the City Clinical Hospital No. 52. The median age was 53 years (range 43–66 years). In two patients, tandem transplantation was performed. Melphalan 140 mg/m2 (n = 10) was administered for pre-transplant conditioning. In 4 patients, bendamustine 200 mg/m2 was added to melphalan in the conditioning regimen. The median transfused СD34+ cell count was 3.61 × 106/kg (range 1.34–9.69 × 106/kg). By the time of completing bortezomib and/or lenalidomide induction therapy, complete remission (CR) was achieved in 5 patients, other 5 patients showed very good partial remission (VGPR), and in 4 patients partial remission (PR) was registered.

RESULTS. As reported by the control follow-up on Day +100 after auto-HSCT, all patients demonstrated further deepening of antitumor response. By this time, CR in 11 (79 %) patients and VGPR in 2 (14 %) patients were registered, whereas 1 (7 %) patient maintained PR. Renal response and HD independence were achieved in 8 (57 %) out of 14 patients enrolled in the trial. In the total group (n = 14), the 3-year event-free survival was 50 % and overall survival was 78 %.

CONCLUSION. Dialysis-dependent renal failure in MM patients is no contraindication to auto-HSCT. The latter will improve chemotherapy outcomes and make it possible to achieve renal response and HD independence.

PDF_2025-18-2-171-176 (Russian)

References

  1. 1. Irish AB, Winearls CG, Littlewood T. Presentation and survival of patients with severe renal failure and myeloma. QJM. 1997;90(12):773–80. doi: 10.1093/qjmed/90.12.773.
  2. 2. Bladé J, Fernandez-Llama P, Bosch F, et al. Renal failure in multiple myeloma: Presenting features and predictors of outcome in 94 patients from a single institution. Arch Intern Med. 1998;158(17):1889–93. doi: 10.1001/archinte.158.17.1889.
  3. 3. Riccardi A, Gobbi PG, Ucci G, et al. Changing clinical presentation of multiple myeloma. Eur J Cancer. 1991;27(11):1401–5. doi: 10.1016/0277-5379(91)90020-e.
  4. 4. Analysis and management of renal failure in fourth MRC myelomatosis trial: MRC working party on leukaemia in adults. Br Med J (Clin Res Ed). 1984;288(6428):1411–6. doi: 10.1136/bmj.288.6428.1411.
  5. 5. Kyle RA, Gertz MA, Witzig TE, et al. Review of 1027 patients with newly diagnosed multiple myeloma. Mayo Clin Proc. 2003;78(1):21–33. doi: 10.4065/78.1.21.
  6. 6. Knudsen LM, Hjorth M, Hippe E. Renal failure in multiple myeloma: reversibility and impact on the prognosis. Nordic Myeloma Study Group. Eur J Haematol. 2000;65(3):175–81. doi: 10.1034/j.1600-0609.2000.90221.x.
  7. 7. Augustson BM, Begum G, Dunn JA, et al. Early Mortality After Diagnosis of Multiple Myeloma: Analysis of Patients Entered Onto the United Kingdom Medical Research Council Trials Between 1980 and 2002—Medical Research Council Adult Leukaemia Working Party. J Clin Oncol. 2005;23(36):9219–26. doi: 10.1200/JCO.2005.03.2086.
  8. 8. Evison F, Sangha J, Yadav P, et al. A population-based study of the impact of dialysis on mortality in multiple myeloma. Br J Haematol. 2018;180(4):588–91. doi: 10.1111/bjh.14394.
  9. 9. Barlogie B, Shaughnessy J, Tricot G, et al. Treatment of multiple myeloma. Blood. 2004;103(1):20–32. doi: 10.1182/blood-2003-04-1045.
  10. 10. Attal M, Harousseau JL, Stoppa AM, et al. A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma. Intergroupe Francais du Myelome. N Engl J Med. 1996;335(2):91–7. doi: 10.1056/NEJM199607113350204.
  11. 11. Child JA, Morgan GJ, Davies FE, et al. High-dose chemotherapy with hematopoietic stem-cell rescue for multiple myeloma. Engl J Med. 2003;348(19):1875–83. doi: 10.1056/NEJMoa022340.
  12. 12. Knudsen LM, Nielsen B, Gimsing P, Geisler C. Autologous stem cell transplantation in multiple myeloma: outcome in patients with renal failure. Eur J Haematol. 2005;75(1):27–33. doi: 10.1111/j.1600-0609.2005.00446.x.
  13. 13. Lee C-K, Zangari M, Barlogie B, et al. Dialysis-dependent renal failure in patients with myeloma can be reversed by high-dose myeloablative therapy and autotransplant. Bone Marrow Transplant. 2004;33(8):823–8. doi: 10.1038/sj.bmt.1704440.
  14. 14. Waszczuk-Gajda A, Lewandowski Z, Drozd-Sokolowska J, et al. Autologous peripheral blood stem cell transplantation in dialysis-dependent multiple myeloma patients-DAUTOS Study of the Polish Myeloma Study Group. Eur J Haematol. 2018;101(4):475–85. doi: 10.1111/ejh.13101.
  15. 15. Parikh GC, Amjad AI, Saliba RM, et al. Autologous hematopoietic stem cell transplantation may reverse renal failure in patients with multiple myeloma. Biol Blood Marrow Transplant. 2009;15(7):812–6. doi: 10.1016/j.bbmt.2009.03.021.
  16. 16. Dimopoulos M, Sonneveld P, Leung N, et al. International Myeloma Working Group Recommendations for the Diagnosis and Management of Myeloma-Related Renal Impairment. J Clin Oncol. 2016;34(13):1544–57. doi: 10.1200/JCO.2015.65.0044.
  17. 17. Farag S, Jeker B, Bacher U, et al. Dose-intensified bendamustine and melphalan (BenMel) conditioning before second autologous transplantation in myeloma patients. Hematol Oncol. 2018;36(4):671–8. doi: 10.1002/hon.2546.
  18. 18. Mark TM, Reid W, Niesvizky R, et al. A phase 1 study of bendamustine and melphalan conditioning for autologous stem cell transplantation in multiple myeloma. Biol Blood Marrow Transplant. 2013;19(5):831–7. doi: 10.1016/j.bbmt.2013.02.013.
  19. 19. Gomez-Arteaga A, Mark TM, Guarneri D, et al. High-dose bendamustine and melphalan conditioning for autologous stem cell transplantation for patients with multiple myeloma. Bone Marrow Transplant. 2019;54(12):2027–38. doi: 10.1038/s41409-019-0587-0.
  20. 20. Durie BGM, Harousseau J-L, San-Miguel J, et al. International uniform response criteria for multiple myeloma. Leukemia. 2006;20(9):1467–73. doi: 10.1038/sj.leu.2404284.
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