results of autologous hematopoietic stem cell transplantation in patients with multiple myeloma (mm) and renal impairment: a retrospective single-center study

Background: to assess the efficacy of autologous hematopoietic stem cell transplantation (auto-hsct) in multiple myeloma (mm) patients with acute renal failure. materials and methods: a retrospective single-center study included 64 patients (30 men, 34 women) with mm and kidney damage at the onset of the disease, aged 19 to 65 years (median 54), who underwent auto-hsct from 2013 to 2019. 23 patients (36%) were dialysis-dependent at the time of diagnosis. the analysis was carried out in two groups: the hd- group (patients who were independent of hemodialysis during auto-hsct, n = 54), and the hd + group (patients who underwent auto-hsct while treated with programmed hemodialysis, n = 10). research results were statistically processed using the statistica software (version 10.0); the data obtained were presented graphically. statistical analysis was performed using survival analysis (using the kaplan-meier method, with a log-rank test) and frequency analysis (using contingency tables and fisher's test). results: the patients dependent on hemodialysis were significantly more likely to require red blood cell transfusions compared to the dialysis-independent patients (100% versus 35%, p = 0.0001). reactivation of a herpes viral infection and reversible toxic encephalopathy developed significantly more often in the patients from the “hd +” group compared with the patients from the “hd-” group (30% versus 6%, p = 0.04 and 20% versus 0%, p = 0.02, respectively). as a result of the treatment (induction + auto-hsct), 14 patients (61%) became hemodialysis-independent. there was no transplant-related mortality. with a median follow-up of 48 months, the 5-year overall survival (os) and progression-free survival (pfs) were 70% and 42%, respectively. conclusion: auto-hsct is a safe and effective treatment for patients with mm complicated by acute kidney injury. fourteen of 23 (61%) patients became dialysis-independent.