Abstract：
Renal failure is a common feature of multiple myeloma (MM) that occurs in 20%-40% of newly diagnosed patients with MM and is the result of monoclonal immunoglobulin light chains. Many studies have examined the effect of autologous stem cell transplantation (ASCT) in MM patients with renal impairment and the safety of performing the transplantation in patients with renal failure. This study aimed to compare renal function before and after ASCT in Egyptian MM patients with renal insufficiency to evaluate the effect of ASCT on renal recovery. Our study included 31 MM patients with renal impairment out of 400 patients who met the criteria of the International Myeloma Working Group for symptomatic MM. The estimated glomerular filtration rate (eGFR) calculated by the Modification of Diet in Renal Disease formula was compared before and after the transplant. Only four patients (12.9%) were dependent on dialysis. Six of those with a history of hemodialysis (HD) who were either dependent on dialysis or dialyzed according to need achieved independence from HD. There was no significant correlation between the degree of renal impairment and the disease\'s status at the time of transplantation (P = 0.86). The study showed significant improvements in serum creatinine levels compared with its value before the transplant (P = 0.016) and in eGFR (P = 0.004). In total, 45% of patients achieved renal improvement, shown by a 25% increase in GFR above the baseline. There was a significant improvement of renal function after ASCT in MM patients with renal impairment.
摘要：
肾衰竭是多发性骨髓瘤（MM）的常见特征，在20％-40％的新诊断MM患者中发生，并且是单克隆免疫球蛋白轻链的结果。许多研究已经检查了自体干细胞移植（ASCT）在肾损害的MM患者中的作用以及在肾衰竭患者中进行移植的安全性。这项研究旨在比较埃及MM肾功能不全患者ASCT前后的肾功能，以评估ASCT对肾脏恢复的影响。我们的研究包括符合国际骨髓瘤工作组标准的400名患者中31名患有肾功能损害的MM患者。在移植前后比较了通过修改肾脏疾病饮食公式计算的估计肾小球滤过率（eGFR）。只有4名患者（12.9%）依赖透析。有血液透析（HD）病史的人中有六名依赖透析或根据需要透析的人独立于HD。移植时肾功能损害程度与疾病状态无显著相关性(P=0.86)。该研究显示，与移植前相比，血清肌酐水平显着改善（P=0.016）和eGFR（P=0.004）。总的来说,45%的患者实现肾脏改善，GFR比基线增加25%。肾损害MM患者ASCT术后肾功能明显改善。
