Kidney Transplant Outcomes of Patients With Multiple Myeloma.
Kidney Transplant Outcomes of Patients With Multiple Myeloma.
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DOI：
10.1016/j.ekir.2022.01.003
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发表时间：
2022-04
影响因子：
6
通讯作者：
Leung, Nelson
中科院分区：
文献类型：
--
作者：
Heybeli, Cihan;Bentall, Andrew J.;Alexander, Mariam Priya;Amer, Hatem;Buadi, Francis K.;Dispenzieri, Angela;Dingli, David;Gertz, Morie A.;Issa, Naim;Kapoor, Prashant;Kukla, Aleksandra;Kumar, Shaji;Lorenz, Elizabeth C.;Rajkumar, S. Vincent;Schinstock, Carrie A.;Leung, Nelson
关于多发性骨髓瘤（MM）患者肾移植（KTx）结局的数据非常有限。我们调查了1994年至2019年期间接受KTx的MM患者的结局。共纳入11例患者的12例移植。在KTx时，6例被分类为具有严格完全缓解（CR），2例为CR，2例为非常好的部分缓解（VGPR），2例为部分缓解（PR）。KTx后中位随访40个月（最小-最大，5-92），9例移植（75%）发生血液学进展。有3例移植物（25%）失败，5例患者（45.5%）在功能正常的同种异体移植物中死亡。1年和5年的移植物存活率分别为82.5%和66%。队列的1年、3年和5年无进展生存率（PFS）分别为83.3%、55.6%和44.4%。在任何时间（KTx前和/或KTx后）接受硼替佐米治疗的患者未达到估计的中位PFS，而从未接受硼替佐米治疗的患者为24个月（P = 0.281）。该队列1年、3年和5年的总生存率（OS）分别为81.8%、61.4%和61.4%。在任何时间接受硼替佐米治疗的患者的OS分别为87.5%、72.9%和72.9%，从未接受硼替佐米治疗的患者的OS分别为66.7%、33.3%和33.3%（P = 0.136）。所有死亡均因血液学进展或治疗相关并发症而发生。在KTx之前或之后接受硼替佐米治疗的骨髓瘤患者的肾移植结果似乎更有利。然而，MM中KTx后复发仍然很常见。需要更多的研究来更好地确定谁从KTx中受益。
Data on kidney transplantation (KTx) outcomes of patients with multiple myeloma (MM) are very limited. We investigated the outcomes of patients with MM who underwent KTx between 1994 and 2019. A total of 12 transplants from 11 patients were included. At the time of KTx, 6 were classified as having stringent complete response (CR), 2 as CR, 2 as very good partial response (VGPR), and 2 as partial response (PR). With a median follow-up of 40 (minimum–maximum, 5–92) months after KTx, hematologic progression occurred in 9 transplants (75%). There were 3 grafts (25%) that failed, and 5 patients (45.5%) experienced death with functioning allografts. Graft survival at 1 and 5 years was 82.5% and 66%, respectively. Progression-free survival (PFS) rates of the cohort at 1, 3, and 5 years were 83.3%, 55.6%, and 44.4%, respectively. The estimated median PFS of patients who received bortezomib at any time (pre-KTx and/or post-KTx) was not reached, whereas it was 24 months for those who never received bortezomib (P = 0.281). Overall survival (OS) rates of the cohort at 1, 3, and 5 years were 81.8%, 61.4%, and 61.4%, respectively. OS of patients who received bortezomib at any time was 87.5%, 72.9%, and 72.9%, and that for those who never received bortezomib was 66.7%, 33.3%, and 33.3% (P = 0.136). All deaths occurred owing to hematologic progression or treatment-related complications. Kidney transplant outcomes of patients with myeloma who received bortezomib before or after KTx seem to be more favorable. Nevertheless, relapse after KTx in MM is still common. More studies are needed to better determine who benefits from a KTx.
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影响因子：
12.8
作者：
Gonsalves WI;Leung N;Rajkumar SV;Dispenzieri A;Lacy MQ;Hayman SR;Buadi FK;Dingli D;Kapoor P;Go RS;Lin Y;Russell SJ;Lust JA;Zeldenrust S;Kyle RA;Gertz MA;Kumar SK
通讯作者：
Kumar SK
活跃多发性骨髓瘤或闷闷的骨髓瘤的肾脏移植：病例对照研究。
影响因子：
4.6
作者：
Kormann R;Pouteil-Noble C;Muller C;Arnulf B;Viglietti D;Sberro R;Sayegh J;Durrbach A;Dantal J;Girerd S;Pernin V;Albano L;Rondeau E;Peltier J
通讯作者：
Peltier J
影响因子：
6
作者：
Nasr SH;Leung N;Heybeli C;Cornell LD;Alexander MP
通讯作者：
Alexander MP
影响因子：
8.9
作者：
Kapoor, Prashant;Fonseca, Rafael;Kumar, Shaji
通讯作者：
Kumar, Shaji
影响因子：
6.5
作者：
Davies, FE;Forsyth, PD;Morgan, GJ
通讯作者：
Morgan, GJ