PATIENTS WITH MULTIPLE-MYELOMA REQUIRING LONG-TERM DIALYSIS - PRESENTING FEATURES, RESPONSE TO THERAPY, AND OUTCOME IN A SERIES OF 20 CASES

From January 1982 to December 1993, 30 patients with multiple myeloma (MM) required haemodialysis (HD) at our institution. The subgroup of 2 0 patients who survived more than 2 months on HD is the subject of thi s study. Four patients were already on HD, due to previous nephropathy , when MM was diagnosed. 13 patients presented with acute renal failur e and were on dialysis from the time of diagnosis, The remaining three cases developed renal failure later in the course of the disease. The objective response rate was 40% (8/20). Only two patients could disco ntinue HD (one had a late partial recovery and one received a kidney g raft), Mean hospitalization per year was 19.3 d. The subgroup of patie nts who survived < 1 year spent a mean of 38.3 d in hospital. Whereas in the subgroup with a survival > 1 year mean hospitalization days was 9.6 (P < 0.001), The median survival was 20 months and six patients s urvived for > 3 years, In summary, patients with MM and severe renal f ailure who survive the first 2 months on dialysis have an objective re sponse rate to chemotherapy of 40% and a median survival of almost 2 y ears, with 30% long-term survivors.