High Dose Therapy Followed by Autologous Transplantation for Myeloma Patients With Severe Renal Impairment

  • STATUS
    Not Recruiting
  • End date
    Sep 1, 2022
  • participants needed
    150
  • sponsor
    Institut de Cancérologie de la Loire
Updated on 27 January 2021
multiple myeloma
chronic disease
renal impairment
bone marrow procedure
nephropathy
autograft

Summary

Multiple myeloma (MM) is a malignant plasma cell disorder, characterized by the presence of more than 10 % of clonal plasma cells in the bone marrow. Therapeutic intervention is recommended when at least one of the myeloma defining events occurs (CRAB features). Renal impairment (RI) is one of the most common complications of MM, accounting for 20-30 % of MM patients at diagnosis and 40-50% of patients during the course of their disease. To date, there is no defined consensus for the management of myeloma patients with renal failure. It is then of clinical importance to better considering available therapeutic options to improve responses and survival of these patients.

Description

RI is associated with poor prognosis and short median survival (32 months vs 55 months for MM patients with normal renal function). Thus, RI remains a major challenge for hematologists, including decisions on optimal anti-myeloma therapy, potential dialysis, supportive care and quality of life. The combination of a proteasome inhibitor and an immunomodulator is the preferred induction treatment for newly diagnosed transplant-eligible MM patients. After induction, high-dose therapy with Autologous Stem Cell Transplant (ASCT) is the standard of care for these patients. However, concerns related to management of comorbidities and treatment side effects question about therapeutic options for patients with severe renal damage. Of interest, recent studies argued that high-dose therapy followed by ASCT could be a feasible and safe method for renal failure MM patients. Yet, these observations on small sample size patients groups need to be confirmed with standardized conditions. This study proposes to evaluate the efficacy and the safety of this therapeutic strategy in MM patients with severe renal impairment.

Details
Condition Renal Failure, Multiple Myeloma, Lymphoproliferative Disorder, Kidney Failure (Pediatric), Kidney Failure, Lymphoproliferative disorders, renal insufficiency, multiple myeloma (mm)
Treatment Data Collection
Clinical Study IdentifierNCT03234335
SponsorInstitut de Cancérologie de la Loire
Last Modified on27 January 2021

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