264 Influence of Race on Outcomes in Multiple Myeloma Patients with Renal Dysfunction Undergoing Autologous Stem Cell Transplant

Track: Poster Abstracts
Wednesday, February 11, 2015, 6:45 PM-7:45 PM
Grand Hall CD (Manchester Grand Hyatt)
Lakshminarayanan Nandagopal, MD , Department of hematology and medical oncology, karmanos cancer intitute, detroit, MI
Christine Ye, MD , department of hematology and medical oncology, Karmanos cancer intitute, detroit, MI
Marie Ventimiglia , BMT Program, Wayne State University Hospital, Detroit, MI
Muneer H. Abidi, MD , Karmanos Cancer Institute/ Wayne State University, Detroit, MI
Lois Jeanne Ayash, MD , Karmanos Cancer Institute/ Wayne State University, Detroit, MI
Jeffrey Zonder, MD , Department of hematology and medical oncology, Karmanos cancer intitute, Detroit, MI
Lawrence Lum, MD, DSc , Oncology, Karmanos Cancer Institute, Detroit, MI
Joseph Uberti, MD , Karmanos Cancer Institute/ Wayne State University, Detroit, MI
Voravit Ratanatharathorn, MD , Karmanos Cancer Institute/ Wayne State University, Detroit, MI
Divaya Bhutani, MD , Oncology, Karmanos Cancer Institute, Detroit, MI
Abhinav Deol, MD , Karmanos Cancer Institute/ Wayne State University, Detroit, MI
Presentation recording not available for download or distribution as requested by the presenting author.

Approximately 20% of Multiple Myeloma (MM) patients (pts) have renal dysfunction(RD) at the time of diagnosis and some more may develop it during the course of their disease. In this restrospective review we studied outcomes in pts of different races with RD undergoing autologous stem cell transplant (ASCT) for MM.  

Between June 2005 and December 2013, we identified 107 pts with MM with RD (creatinine clearance < 60 ml/min/1.73 m2) who were not on hemodialysis and underwent ASCT at our institution. Of the 107 pts, 76 were caucasian(C) pts and 31 were identified as other (O) races (25 African American, one Hispanic, two Middle-eastern, three Asian).  There were no statistically significant differences in the characteristics between the 2 groups. Approximately a quarter of the pts received  their melphalan dose on the inpatient unit in both groups. During the hospitalization all pts received G-CSF from Day +6 till absolute neutrophil count ≥ 1500/µl and antimicrobial prophylaxis with norfloxacin, acyclovir and fluconazole.

The median follow up was 35.9 months (range, 5.1-106.3). One patient in the C group died 98 days after ASCT and had evidence of disease progression. There were no deaths in the O group during the 100 days after ASCT. Table 1 shows post ASCT disease status and details about post ASCT maintenance therapy. There were no statistically significant differences between the groups in disease status or change in disease status at day 100 post ASCT.  Although more patients in the C group received maintenance therapy post ASCT, this difference was not statistically significant. Figures 1 and 2 show the relapse free survival (RFS)and overall survival (OS) of both groups. The median RFS for C and O groups were 32.3 and 20.9 months (p =0.63, log rank), respectively. The median OS of the C and O groups were 73.1 and 47.8 month (p=0.31, log rank), respectively.

Our limited experience suggests that there was no effect of race in the post ASCT outcomes for MM pts with RD. ASCT was safe with acceptable transplant related mortality and good long -term outcomes for MM pts with renal dysfunction.

Table 1: Disease status at Day 100 post ASCT and Maintenance Therapy post ASCT

Caucasian

(N=76)

Other

(N=31)

P Value

Disease Status

CR

26 (34%)

6 (19%)

0.5

VGPR

20 (26%)

12 (38%)

PR

17 (22%)

6 (19%)

SD

7 (9%)

4 (13%)

PD

2 (3%)

2 (7%)

Not available

4 (6%)

1 (3%)

Change in Disease Status

Improved

23 (30%)

13 (42%)

0.66

Unchanged

45 (59%)

15 (48%)

Worsened

4 (6%)

2 (7%)

Not available

4 (6%)

1 (3%)

Maintenance Therapy

IMid

40 (53%)

9 (29%)

0.15

PI

2 (3%)

1 (3%)

None

29 (38%)

19 (61%)

Not Known

5 (7%)

2 (7%)

Disclosures:
M. H. Abidi, Seattle Genetics, Inc., study investigator: Research Funding and Speakers Bureau

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