Role of prognostic scores in the evolution of renal involvement in patients with multiple myeloma after bone marrow transplantation

Abstract

Introduction: Treatment of multiple myeloma (MM) with chemotherapy and autologous bone marrow transplantation (BMT) commonly results in renal dysfunction associated with early mortality. Prognostic scores for MM are assessed by either Durie and Salmon (DS) or International Staging System (ISS) methods. Few studies have examined the relationship between these scores and renal damage after BMT. Aims: To evaluate DS and ISS prognostic scores as they relate to renal function and mortality in MM patients who have undergone BMT. Methods: Retrospective, observational cohort of 95 MM patients who underwent BMT between 2012 and 2014. Renal function was assessed using data on proteinuria, serum creatinine, and estimated glomerular filtration rate from the time of hospital admission to 6 months post-BMT. Results: Neither score was significantly associated with death or proteinuria, but patients in DS stage IIIB were 12.8 times more likely to experience renal dysfunction than those in DS stage I–II. Both DS and ISS scores reflected a progressive increase in the chance of renal functional impairment with increased disease staging. Conclusions: The prognostic methods studied were useful in the initial recognition of renal dysfunction and after 6 months post BMT, the DS score was still able to predict the reduction of eGFR. Patients in the advanced stages of MM were associated with altered renal function, and these results could help to establish early treatment strategies to reduce the risk of renal damage.