Risk factors for the development of orthostatic hypotension during autologous stem cell transplant in patients with multiple myeloma

Authors

Matthew Ho, Department of Internal Medicine, Mayo Clinic, Rochester, MN, USA.
Maria Moscvin, Amyloidosis program, Division of Hematology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Soon Khai Low, Rochester Regional HealthFollow
Benjamin Evans, Amyloidosis program, Division of Hematology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Sara Close, LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Robert Schlossman, LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Jacob Laubach, LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Claudia Paba Prada, LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Brett Glotzbecker, Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, USA.
Paul G. Richardson, LeBow Institute for Myeloma Therapeutics and Jerome Lipper Multiple Myeloma Center, Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
Giada Bianchi, Amyloidosis program, Division of Hematology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Department

Internal Medicine

Document Type

Article

Publication Title

Leukemia & Lymphoma

Abstract

Orthostatic hypotension (OH) is a well-recognized phenomenon occurring in multiple myeloma (MM) patients undergoing autologous stem cell transplant (ASCT), and is associated with significant morbidity and mortality. A retrospective analysis of patients admitted for first ASCT between June 2012 and April 2014 found that 161/222 (73%) patients were diagnosed with OH during the course of ASCT, including 51 patients who were found to have OH on the day of first orthostatic vitals check. Excluding these 51 patients, 110/171 (64%) patients developed OH during the peri-transplant period, at a median of 7 days post ASCT (95% CI: 6.5-8.5). OH did not significantly impact length of hospitalization, progression free and overall survival. Multivariable analysis revealed four risk factors (i.e. ≥ 0.5% weight loss/day, white race, gabapentin, antihypertensives) and two protective factors (i.e. antihistamine, proton pump inhibitor) associated with the development of peri-transplant OH.

First Page

2403

Last Page

2412

DOI

10.1080/10428194.2022.2084729

Volume

63

Issue

10

Publication Date

10-2022

PubMed ID

35699975

Recommended Citation

Ho, M., Moscvin, M., Low, S. K., Evans, B., Close, S., Schlossman, R., Laubach, J., Prada, C. P., Glotzbecker, B., Richardson, P. G., & Bianchi, G. (2022). Risk factors for the development of orthostatic hypotension during autologous stem cell transplant in patients with multiple myeloma. Leukemia & Lymphoma, 63 (10), 2403-2412. https://doi.org/10.1080/10428194.2022.2084729