Table 1.
Characteristics of patients who underwent first auto transplant for MM in 2008-2013 and reported with CIBMTR
| Renal function at HCT1
|
|||
|---|---|---|---|
| Variable | Normal/Mild | Moderate | Severe/RI |
| Number of patients | 1240 | 185 | 67 |
| Age at transplant, years | |||
| median age (range) | 59 (28-78) | 62 (33-75) | 60 (23-74) |
| 18-39 | 39 (3) | 6 (3) | 5 (7) |
| 40-49 | 189 (15) | 20 (11) | 7 (10) |
| 50-59 | 463 (37) | 46 (25) | 22 (33) |
| 60-69 | 474 (38) | 97 (52) | 27 (40) |
| 70+ | 75 (6) | 16 (9) | 6 (9) |
| Gender, Male | 741 (60) | 97 (52) | 36 (54) |
| Race | |||
| Caucasian | 938 (76) | 145 (78) | 53 (79) |
| African American | 226 (18) | 30 (16) | 10 (15) |
| Others2 | 38 (3) | 4 (2) | 3 (4) |
| Missing | 38 (3) | 6 (3) | 1 (1) |
| Karnofsky Score, ≥ 90% | 700 (56) | 106 (57) | 25 (37) |
| Adjusted HCTCI scores (Renal comorbidity excluded) | |||
| 0 | 505 (41) | 62 (34) | 29 (43) |
| 1 | 188 (15) | 28 (15) | 11 (16) |
| 2 | 192 (15) | 26 (14) | 9 (13) |
| 3 | 175 (14) | 32 (17) | 8 (12) |
| >3 | 158 (13) | 36 (19) | 9 (13) |
| Missing | 22 (2) | 1 (<1) | 1 (1) |
| Disease-related | |||
| Immunochemical subtype | |||
| IgG | 722 (58) | 96 (52) | 21 (31) |
| IgA | 259 (21) | 27 (15) | 7 (10) |
| Light chain only | 219 (18) | 56 (30) | 37 (55) |
| Others3 | 15 (1) | 4 (2) | 2 (3) |
| Non-secretory | 25 (2) | 2 (1) | 0 |
| ISS Stage III at diagnosis | 326 (26) | 84 (45) | 43 (64) |
| Cytogenetic abnormality (FISH and/or karyotype) | |||
| High risk (HR)4 | 151 (12) | 27 (15) | 13 (19) |
| Non-HR | 876 (71) | 125 (68) | 45 (67) |
| Missing5 | 213 (17) | 33 (18) | 9 (13) |
| Serum creatinine at diagnosis | |||
| median (range) | 1 (<1-14) | 2 (<1-18) | 5 (2-17) |
| < 2 mg/dl | 926 (75) | 77 (42) | 1 (1) |
| ≥ 2 mg/dl | 94 (8) | 72 (39) | 48 (72) |
| Missing | 220 (18) | 36 (19) | 18 (27) |
| Serum creatinine prior to transplant | |||
| median (range) | 1 (<1-2) | 1 (1-2) | 3 (2-12) |
| < 2 mg/dL | 1240 | 166 (90) | 2 (3) |
| ≥ 2 mg/dL | 0 | 19 (10) | 65 (97) |
| GFR at transplant (mL/min per 1·73m2), median(range) | 97 (60-222) | 49 (31-60) | 19 (5-29) |
| Transplant-related | |||
| Lines of chemotherapy | |||
| 1 | 988 (80) | 144 (78) | 37 (55) |
| 2 | 199 (16) | 32 (17) | 22 (33) |
| >2 | 53 (4) | 9 (5) | 8 (12) |
| Chemotherapy | |||
| VTD | 84 (6) | 25 (14) | 15 (22) |
| RVD | 516 (42) | 59 (32) | 15 (22) |
| CVD | 154 (12) | 31 (17) | 12 (18) |
| VD6 | 146 (12) | 33 (18) | 12 (18) |
| RD | 230 (19) | 31 (17) | 4 (6) |
| TD | 87 (7) | 5 (2) | 4 (6) |
| VAD/similar | 23 (2) | 1 (<1) | 5 (8) |
| Mobilization strategy | |||
| GCSF | 761 (61) | 104 (56) | 50 (75) |
| GCSF+chemo | 307 (25) | 45 (24) | 16 (24) |
| GCSF+pleraxifor | 172 (14) | 36 (19) | 1 (1) |
| Disease status at transplant | |||
| sCR/CR | 228 (18) | 37 (20) | 11 (16) |
| VGPR | 385 (31) | 53 (29) | 23 (34) |
| PR | 534 (43) | 82 (44) | 29 (43) |
| SD | 62 (5) | 8 (4) | 3 (4) |
| Rel/Prog | 31 (3) | 5 (3) | 1 (1) |
| Melphalan dose, mg/m2 | |||
| 140 | 98 (8) | 47 (25) | 45 (67) |
| 200 | 1142 (92) | 138 (75) | 22 (33) |
| Time from diagnosis to transplant | |||
| < 6 months | 474 (38) | 66 (36) | 17 (25) |
| 6 - 12 months | 766 (62) | 119 (64) | 50 (75) |
| Year of transplant | |||
| 2008 | 356 (29) | 58 (31) | 26 (39) |
| 2009 | 135 (11) | 22 (12) | 10 (15) |
| 2010 | 127 (10) | 17 (9) | 6 (9) |
| 2011 | 178 (14) | 19 (10) | 6 (9) |
| 2012 | 173 (14) | 32 (17) | 5 (7) |
| 2013 | 271 (22) | 37 (20) | 14 (21) |
| Median follow-up of survivors (range), months | 48 (3-97) | 48 (4-96) | 60 (6-75) |
Evaluated by glomerular filtration rate (GFR), mL/min per 1·73m2· Abbreviated MDRD study equation is: GFR (mL/min per 1·73m2) = 186 × (SCr)−1·154 × (Age)−0·203 × (0·742 if female) × (1·210 if African-American)· SCr is serum creatinine concentration at transplant in mg/dL.
- Normal/Mild – GFR score≥60
- Moderate - GFR score (30-59)
- Severe/Renal Failure – GFR score <30
Asian (30), American Indian (12), Islander (3).
IgD (16), IgE (1), IgM (4).
High risk genomic abnormalities consist of t(4;14), t(14;16), del17p, hypodiploidy and any abnormality in chromosome 1· All other cytogenetic lesions are considered non high-risk.
Including No metaphases (9), Cytogenetics not tested (157) and Unknown (89).
Including Bortezomib +Doxil+Dexamethasone (2).
HCT-CI, hematopoietic cell transplantation-comorbidity index; ISS, International Staging System; FISH, fluorescence in situ hybridization; MM, multiple myeloma; CIBMTR, Center for International Blood and Marrow Transplantation; VTD, bortezomib, thalidomide, dexamethasone; RVD, lenalidomide, bortezomib, dexamethasone; VD, bortezomib, dexamethasone; RD, lenalidomide dexamethasone; TD, thalidomide, dexamethasone; VAD, vincristine, doxorubicin, dexamethasone; GCSF, granulocyte-colony stimulating factor; sCR, stringent complete response; CR, complete response; VGPR, very good partial response; PR, partial response; SD, stable disease; RI, renal insufficiency