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LDH and renal function are prognostic factors for long-term outcomes of multiple myeloma patients undergoing allogeneic hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 55, pages 1736–1743 (2020)Cite this article

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Abstract

Allogeneic hematopoietic stem cell transplantation (allo-SCT) may offer a cure for selected patients with multiple myeloma (MM). Effective prognostic markers to guide patient selection are warranted. We retrospectively studied a cohort of 100 relapsed refractory MM patients who underwent allo-SCT. With a median follow-up of 12.2 years, median overall survival (OS) and progression-free survival (LFS) were 9.2 months and 5.6 months, respectively. 5-years OS and PFS were was 18.0% and 16.8%. The cumulative incidence of 5-years relapse was 45.9% and non-relapse mortality (NRM) 36.0%. In a multivariable Cox model, decreasing albumin, increasing lactate dehydrogenase (LDH), advanced disease, and mismatched donors were predictive of both reduced OS and PFS. The probability of 5-years OS was higher in patients with LDH below vs. the upper limit of normal (22% vs. 5%, p = 0.004). In the multivariable analysis, the hazard of NRM was increased with low albumin, mismatched donor type, and declining estimated glomerular filtration rate (eGFR). Patients with a low eGFR had a 5-year NRM incidence of 31% vs. 56% in patients with higher levels (p = 0.02). Graft-versus-host disease was not associated with improved outcomes. In conclusion, LDH, renal function, and albumin are highly informative of outcomes in MM patients treated with allo-SCT.

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Fig. 1: Outcomes following allo-HSCT in patients with multiple myeloma.

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  • 12 March 2020

    Following publication, the authors noticed an error in the title of this article. The word “transplantation” was missed off the end of the title. The title has now been corrected to “LDH and renal function are prognostic factors for long-term outcomes of multiple myeloma patients undergoing allogeneic hematopoietic stem cell transplantation” in both the PDF and HTML versions of this article.

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Acknowledgements

The study was supported by the Varda and Boaz Dotan Research Center in Hemato-oncology, Idea Award Research Grant, Tel-Aviv University.

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  1. These authors contributed equally: Roni Shouval, Omer Teper

Authors and Affiliations

  1. Hematology and Bone Marrow Transplantation Division, Chaim Sheba Medical Center, Tel-Hashomer, Sackler School of Medicine, Tel-Aviv University, 6997801, Tel-Aviv, Israel

    Roni Shouval, Omer Teper, Joshua A. Fein, Ivetta Danylesko, Noga Shem Tov, Ronit Yerushalmi, Abraham Avigdor, Elena Vasilev, Hila Magen, Arnon Nagler & Avichai Shimoni

  2. Dr. Pinchas Bornstein Talpiot Medical Leadership Program, Chaim Sheba Medical Center, 52621, Tel-Hashomer, Israel

    Roni Shouval

  3. University of Connecticut Medical Center, Farmington, CT, 06030, USA

    Joshua A. Fein

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Shouval, R., Teper, O., Fein, J.A. et al. LDH and renal function are prognostic factors for long-term outcomes of multiple myeloma patients undergoing allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 55, 1736–1743 (2020). https://doi.org/10.1038/s41409-020-0829-1

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