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Long-Term Impact of ASCT in Patients With Multiple Myeloma

By: Joseph Cupolo
Posted: Wednesday, October 25, 2017

Autologous stem cell transplantation (ASCT) was found to have a positive impact on systolic blood pressure and kidney function in patients with multiple myeloma, according to a recently published study in the Journal of the National Medical Association. Leah Balsam, MD, of the Nassau University Medical Center, East Meadow, New York, and colleagues suggested that ASCT may lower blood pressure over the long term, possibly through its effect on ameliorating renal disease.

According to the investigators, “Renal insufficiency (serum creatinine > 1.3 mg/dLl) is found at the time of diagnosis in almost 50% of [multiple myeloma] patients, and severe renal insufficiency (serum creatinine > 2.0 to 2.5 mg/dL) is seen in greater than 15% of [multiple myeloma] patients.”

This retrospective study centered on 192 patients with multiple myeloma who underwent ASCT. Blood pressure readings and glomerular filtration rates were compared at 4 weeks before ASCT; on the day of ASCT; and at 30, 100, and 180 days after ASCT. Overall, mean systolic blood pressure and diastolic blood pressure on the day of ASCT and at both 30 and 100 days post-ASCT were lower compared with pre-ASCT systolic blood pressure and diastolic blood pressure.

An interesting finding noted by the investigators was that white patients, compared with black patients, had more lasting improvement in the mean values of systolic blood pressure, diastolic blood pressure, and glomerular filtration rate after ASCT. “This may require more intensive blood pressure management and monitoring of their [black patients] renal function,” emphasized Dr. Balsam.