Mel-200 Or Mel-140 , Which One İs More Advantageous? Retrospectively Analysis Of The Multiple Myeloma Patients Treated With Autologous Hematopoetic Stem Cell Transplantation

Abstract

Background Autologous hematopoietic stem cell transplantation (AHSCT) is one of the standard treatment modalities for patients with multiple myeloma (MM) under 65 years of age. Renal failure, significant disease comorbidity, significantly affects treatment choices. There are conflicting data in the literature regarding the dose of melphalan to be used for AHSCT in patients with renal failure and comorbid conditions. This study aimed to compare the efficacy and side effect data of different melphalan doses in patients with renal failure. Material and Methods The study included 107 patients older than 18 years of age with a diagnosis of MM who underwent AHSCT in our center between January 2010 and January 2019. The data of the patients were analyzed retrospectively. Patients were grouped according to estimated glomerular filtration rate (eGFR: <60 or ≥60 mL/min) and melphalan doses (140-200). In addition to renal failure, patients with low-performance scores (ECOG 3 and above) or severe systemic comorbid disease were included in the Mel-140 group. Results Comparative analysis of MEL-140 and MEL-200 doses used for AHSCT showed no significant difference between the two groups regarding side effects, disease-free survival, and overall survival. Engraftment times were similar in both groups. When the patients were analyzed according to eGFR level, the incidence and severity of mucositis were higher in the group with low eGFR levels (p=0.016). The duration of engraftment, complication with a febrile neutropenic attack, and development of septic shock were similar in both groups. Conclusions In addition to renal failure, MEL-140 emerges as a preferable transplant preparation regimen considering its efficacy and side effect profile in patients with low-performance scores or severe systemic comorbidities.

Keywords

• autologous hematopoietic stem cell transplantation
• melphalan
• renal failure
• multiple myeloma

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