Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: Due to recent advances, patients with a history of multiple myeloma (MM) and ESKD are more frequently offered kidney transplantation (Ktx). Existing literature does not offer adequate insight into risks and benefits of Ktx in this population. We analyzed all reported cases in the last 19 years of patients with MM receiving a Ktx to better understand both the hematologic and transplant outcomes.
*Methods: We reviewed all publications from 1/2000 to 11/2019 that included patients with MM who received a Ktx. We complied all patients and evaluated several variables/ outcomes including: demographics, cause of ESKD, treatment for MM, time from treatment to transplant, type of transplant, induction immunosuppression, relapse episodes, time to relapse, de novo malignancies, graft loss and death.
*Results: Ten publications included 36 patients. Majority were published in 2019 (22 of 36). Pre and post transplant characteristics and outcomes are summarized in the respective tables. Due to missing data, percentages did not always add up to 100%. Time from MM treatment (Rx) to Ktx was shorter in those who relapsed/progressed (34 vs 51 months) however the difference was not significant (P=0.22). Similarly, the mean duration between Rx and Ktx was 39 months in those who died vs 57 months in those who survived (P=0.22). The adjusted mean waiting time between Rx and Ktx was not a significant predictor for relapse/progression, death or graft loss. Type of therapy for MM did not impact relapse. Only increased age was found to reduce the odds of relapse (OR 0.88, P=0.021).
*Conclusions: Reports of Ktx in patients with MM are increasing. Our data helps coalesce patient data over the last 20 years and can help inform clinicians and patients on expected hematologic and transplant outcomes in this complex population. Based on our analysis only age influenced the risk of MM relapse although time from Rx to Ktx was numerically shorter in patients with relapse or death.
|Cause of ESKD (%)||Myeloma||76|
|Treatment (%)||Stem cell transplant||75|
|Mean time treatment to Ktx (mo)||45|
|Induction (%)||IL-2 blockade||36|
|D/C graft loss (%)||17|
|New malignancy (%)||9|
To cite this abstract in AMA style:Nair V, Jhaveri K, Abate M. Kidney Transplantation after Multiple Myeloma: The Last 2 Decades [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/kidney-transplantation-after-multiple-myeloma-the-last-2-decades/. Accessed October 25, 2020.
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