Mild renal dysfunction defined by creatinine clearance rate has limited impact on clinical outcomes after allogeneic hematopoietic stem cell transplantation.

ABSTRACT

Creatinine clearance rate (Ccr) is a more accurate indicator of renal function than serum creatinine. Data are sparse regarding the prognostic value of renal impairment calculated using Ccr in patients who undergo allogeneic hematopoietic stem cell transplantation (allo-HSCT). We performed a retrospective analysis of 185 patients who underwent allo-HSCT. These patients were divided into two groups by Ccr (ml/min) before transplantation; one showed normal renal function (Ccr ≥ 60, n = 156) and the other showed mild renal dysfunction (30 ≤ Ccr < 60, n = 29), and transplant outcomes were compared between the groups. We observed no significant difference between the groups in terms of clinical characteristics other than age, estimated glomerular filtration rate, serum creatinine, Ccr predicted by Cockcroft-Gault formula, primary disease, and conditioning intensity. With respect to transplant outcomes, no significant difference was observed in overall survival, relapse, or non-relapse mortality between the two groups. Multivariate analysis demonstrated that 30 ≤ Ccr < 60 before allo-HSCT was not an independent prognostic factor for transplant outcome. In conclusion, these results suggest that patients with mild renal dysfunction, defined as 30 ≤ Ccr < 60 ml/min, can safely undergo allo-HSCT. However, a larger series of patients is needed to evaluate the impact of mild renal dysfunction before allo-HSCT in more detail.