Inpatient mortality of patients with multiple myeloma and renal impairment undergoing autologous stem cell transplantation

Ghulam Rehman Mohyuddin, Saqib Abbasi, Maire Okoniewski, Brian McClune, Al Ola Abdallah, Siddhartha Ganguly, Joseph McGuirk, Leyla Shune

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: Further data are needed on the safety of high-dose melphalan and autologous stem cell transplant (HDM-ASCT) in patients with multiple myeloma (MM) and renal impairment. The objective of our study was to use the National Inpatient Sample (NIS) to determine inpatient mortality for patients with MM and renal impairment undergoing HDM-ASCT, as well as trends over time. Methods: Using the NIS, we tracked hospital admissions for MM patients from 2002 to 2014 who underwent HDM-ASCT, using ICD 9 coding. Results: The total weighted estimate of inpatient admissions for HDM-ASCT among MM patients was 47,253 from 2002 to 2014. A weighted total of 45 and 1709 patients with MM received peritoneal dialysis (PD) and hemodialysis (HD) during HDM-ASCT for MM, respectively. There was a markedly increased risk of inpatient mortality in patients on dialysis undergoing transplant (20.5% for PD patients, 13.8% for HD patients), even after accounting for other comorbidities (odds ratio of inpatient mortality of 6.193 [CI 3.585-10.701]). A significant decrease was noted in inpatient mortality for patients with ESRD undergoing HDM-ASCT over time from 15.6% in 2009 to 5% in 2014 (P <.001). Conclusion: Patients with MM on dialysis undergoing HDM-ASCT are at significantly increased risk of inpatient mortality.

Original languageEnglish (US)
Pages (from-to)571-577
Number of pages7
JournalEuropean Journal of Haematology
Volume105
Issue number5
DOIs
StatePublished - Nov 1 2020

Keywords

  • autologous stem cell transplant
  • hemodialysis
  • multiple myeloma
  • peritoneal dialysis
  • renal impairment

ASJC Scopus subject areas

  • Hematology

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