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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 Q; Dingli, David; Leung, Nelson; Gonsalves, Wilson I; Kapoor, Prashant; Kourelis, Taxiarchis V; Hogan, William J; Kumar, Shaji K; Gertz, Morie A.
Bone Marrow Transplant; 54(11): 1775-1779, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30962503
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.
Selo DaSilva