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Introduction Renal impairment is a common problem in patients with multiple myeloma (MM), and approximately 2-3% of patients develop renal impairment requiring dialysis. Autologous stem cell transplantation (ASCT) is a mainstay of treatment for eligible patients. Although dialysis is not a contraindication to ASCT, further data on the safety of ASCT for these patients is needed, especially for patients on peritoneal dialysis (PD) for which there is limited data available. Methods The National Inpatient Sample (NIS) is a database that provides information on all inpatient hospitalizations in the United States (US), including primary and secondary diagnoses, procedures, length of stay, and disposition. Approximately 20% of admissions are tracked, and weighted estimates are provided regarding the total number of hospitalizations in the US. Using this database, we were able to track hospital admissions for MM patients who underwent ASCT. We reviewed data from 2002 to 2014, using ICD 9 coding. Results During the years 2002-2014, the total weighted estimate of inpatient admissions for ASCT among MM patients was 47,253 (unweighted N=10,231). However, a weighted total of only 45 patients with MM received PD during their hospital stay for ASCT in theUS, as opposed to 1709 patients with MM who received HD during their hospital stay for ASCT. The inpatient mortality rate was numerically higher for patients receiving hemodialysis (HD) compared to PD during their hospital stay for ASCT (20.5% for patients receiving peritoneal dialysis versus 13.8% for patients receiving HD), but this difference was not statistically significant (p=0.58). However, inpatient mortality overall for patients with MM undergoing ASCT not on dialysis was only 1.1%, indicating a markedly increased risk of inpatient mortality for patients with MM on dialysis undergoing ASCT (p The length of stay was comparable between patients receiving HD vs PD (28.7 days for HD vs 26.7 for PD, p=0.69). The length of stay for patients not on dialysis was 17.9 days (p Conclusion Patients with MM requiring either PD or HD undergoing inpatient ASCT are at a significantly increased risk of inpatient mortality. Collaborative efforts are needed to help determine best practices for these patient populations, especially as pertains to patients on PD.

Background Acute myeloid leukemia (AML) remains a disease of high mortality and allogeneic hematopoietic stem cell transplant (HCT) is frequently indicated for its curative potential. However, access can be limited by availability of HLA-matched donors, comorbidities, and performance status. Recently, half-match (haploidentical) donors and reduced-intensity conditioning (RIC) have increasingly been used to alleviate limitations. The objective of this study is to compare outcomes between different types of donors (matched-sibling (MSD) vs matched-unrelated (MUD) vs haploidentical (HI) and to investigate the role of conditioning for patients with AML. Methods In this single-center retrospective study, 253 AML patients receiving first allo-HCT between 2013-2018 were included. Baseline characteristics were collected and the primary outcome of overall survival was evaluated with Kaplan Meier survival analysis and hazard ratios using cox regression models. Baseline difference between these groups were significant for mean age of donor [53.0 years (MSD), 34.8 (HI), 27.8 (MUD); p Results Two-year survival amongst groups stratified by type of donor was not significantly different with 44.0% for MSD (95% CI: 30.4 to 57.6), 53.8% for MUD (95% CI: 44.4 to 63.2), and 53.5% for HI (95% CI: 38.6 to 70.0). When patients were stratified by conditioning type, differences in overall survival were also not statistically significant. Conclusion In this cohort of adult patients with AML, receiving an allo-HCT. Overall survival outcomes were not different between different donor types. This data is consistent with other recent reports demonstrating similar outcomes with haploidentical transplants when compared to matched-donor transplant.

Background Allogeneic hematopoietic stem cell transplant (HCT) is a potentially curative treatment modality for patients with AML. However, the success of transplant is limited by transplant-related mortality. Post-transplant complications have been linked to endothelial damage through derangements in vascular and blood cell homeostasis. The EASIX (Endothelial Activation and Stress Index) score has been studied as a marker for endothelial dysfunction in the setting of allo-HCT using routine laboratory tests (LDH) x serum creatinine (mg/dL)/ Platelets (109 cells/L). The aim of this study is to investigate the prognostic value of a post-transplant day-100 EASIX score in patients with AML. Methods In this single-center retrospective study, 237 patients with AML who underwent a first allo-HCT between 2013-2018 were included. Those alive at 100 days post-transplant were stratified by scores of less than 1, 1-1.99, 2-2.99, and 3 and above. Kaplan Meier survival analysis and hazard ratios using cox regression models were employed to assess overall survival. Results There were no significant baseline differences between groups except for recipient sex [p=0.02]. Survival analysis demonstrated a decreased overall survival with incremental increases in 100-day EASIX scores (p=0.001) with a 2-year overall survival of 67.3% ( Conclusion Endothelial dysfunction contributes significantly to the pathophysiology of complications after transplant. Our data suggests that in patients with AML undergoing HCT, a 100-day EASIX score can be used as a predictor to identify those who are at increased risk of poor outcomes after transplant. This is especially important in settings where patients are discharged from the transplant program after 100 day work-up.

It has been speculated that the number of NSTEMI cases are growing however the exact incidence and use of PCI in the management of these cases is uncertain. Using Nationwide Inpatient Sample database, NSTEMI cases hospitalized between years of 2002-2014 were identified by 9th International