Effect of high-dose melphalan and peripheral blood stem cell transplantation on renal function in patients with multiple myeloma and renal insufficiency: a case report and review of the literature

Ann Hematol. 1999 Apr;78(4):189-91. doi: 10.1007/s002770050499.

Abstract

Multiple myeloma with IgG-lambda monoclonal gammopathy and severe renal impairment with light-chain deposit disease was diagnosed in a 51-year-old man. Following conventional therapy with VAD (vincristine, adriamycin, dexamethasone) a partial remission was achieved. Peripheral blood stem cells (PBSC) were then collected following mobilization with cyclophosphamide and recombinant human granulocyte colony-stimulating factor and enriched for CD34-positive cells by immunoaffinity column. Fourteen months after diagnosis high-dose melphalan was given, followed by infusion of CD34-positive PBSC. Aside from mild oral mucositis and trigonitis, high-dose therapy was tolerated well. After he underwent PBSC transplantation his renal function improved, and the patient has been in in continuous complete remission for 1 year. Thus, high-dose chemotherapy can be safely administered to patients with multiple myeloma and severe renal impairment. Our findings confirm previous reports summarized in the current presentation.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Antineoplastic Agents, Alkylating / administration & dosage*
  • Dose-Response Relationship, Drug
  • Hematopoietic Stem Cell Transplantation*
  • Humans
  • Kidney / physiopathology*
  • Male
  • Melphalan / administration & dosage*
  • Middle Aged
  • Multiple Myeloma / complications*
  • Multiple Myeloma / physiopathology*
  • Renal Insufficiency / complications*
  • Renal Insufficiency / physiopathology*

Substances

  • Antineoplastic Agents, Alkylating
  • Melphalan