Stem Cell Transplants May Improve Kidney Function of Myeloma Patients

Autologous hematopoietic stem cell transplants (auto-HSCT) may reverse kidney failure in one third of multiple myeloma patients, according to authors of an article published in the journal Biology of Blood and Marrow Transplantation.
Stem cell transplants are used to replace stem cells that are killed along with myeloma cells during chemotherapy. Transplantation of stem cells collected from the patient’s bone marrow before chemotherapy is known as an autologous transplant.
About 20 percent of patients diagnosed with multiple myeloma also suffer from kidney failure and five percent are dependent on dialysis.
This recent study reviewed the outcome of 46 patients with multiple myeloma in varying stages of kidney failure. Within 34 months of undergoing an auto-HSCT, 22 percent of myeloma patients showed a complete response and 53 percent showed a partial response. In addition, 32 percent of the patients showed significant improvement in kidney function.
Glomerular filtration rate, the rate at which fluids are filtered by the kidneys, is one of the best indicators of kidney function. Higher rates indicate better kidney function. Among the patients tested, the average glomerular filtration rate increased by 25 percent above baseline.
Auto-HSCT has associated complications and toxicity risks, including infection, inflammation, sever liver injury, and a 10 percent death rate. Therefore, many myeloma patients are not eligible for auto-HSCT.
In this study, two patients died within 100 days of the HSCT. Mild to moderate adverse reactions, unrelated to blood cancers, were seen in 39 percent of patients. These reactions included irregular heart rhythms, fluid accumulation in the lungs, and elevated levels of bilirubin in the blood.
For more information, see the article in the journal Biology of Blood and Marrow Transplantation (abstract).
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