Effect of high-dose melphalan and peripheral blood stem cell transplantation on renal function in patients with multiple myeloma and renal insufficiency: a case report and review of the literature

Multiple myeloma with IgG-lambda monoclonal gammopathy and severe renal imp airment with light-chain deposit disease was diagnosed in a 51-year-old man . Following conventional therapy with VAD (vincristine, adriamycin, dexamet hasone) a partial remission was achieved. Peripheral blood stem cells (PBSC ) were then collected following mobilization with cyclophosphamide and reco mbinant human granulocyte colony-stimulating factor and enriched for CD34-p ositive cells by immunoaffinity column. Fourteen months after diagnosis hig h-dose melphalan was given, followed by infusion of CD34-positive PBSC. Asi de from mild oral mucositis and trigonitis, high-dose therapy was tolerated well. After he underwent PBSC transplantation his renal function improved, and the patient has been in in continuous complete remission for 1 year. T hus, high-dose chemotherapy can be safely administered to patients with mul tiple myeloma and severe renal impairment. Our findings confirm previous re ports summarized in the current presentation.