Renal Outcomes Following Autologous Stem Cell Transplantation in Dialysis-Dependent Patients With Multiple Myeloma: A Single-Center Study From a Low- and Middle-Income Country
Abstract
Background: Multiple myeloma (MM) frequently causes renal impairment, and a subset of patients progresses to end-stage renal disease (ESRD) requiring dialysis. Dialysis dependence has historically been considered a relative contraindication to high-dose conditioning and autologous stem cell transplantation (ASCT). Emerging evidence indicates that ASCT may provide effective hematologic control and, in selected patients, renal recovery.
Methods: We conducted a retrospective case series of five dialysis-dependent patients with MM who underwent ASCT at An-Najah National University Hospital. Demographic and clinical characteristics, transplant variables, supportive-care measures, infectious and noninfectious complications, hematologic recovery, admission and discharge laboratory values, and short-term outcomes were extracted from the medical records.
Results: The five patients had a mean age of 56 years and received reduced-dose melphalan (140 mg/m2), followed by peripheral-blood CD34+ cell infusion. The mean CD34+ collection and infusion doses were 4.3 × 106/kg and 4.1 × 106/kg, respectively. All patients achieved engraftment; mean neutrophil and platelet engraftment occurred on Days 13.0 and 19.4, respectively. Four patients (80%) developed neutropenic fever. Clostridioides difficile and Staphylococcus epidermidis were the most frequently documented pathogens. Two patients developed central line-associated bloodstream infection and septic shock. No 100-day treatment-related…
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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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