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.
Author contributions
GB was responsible for designing the research protocol, interpreting the results, ad writing the manuscript. MH, MM, SC, and PR conducted the search. MH and SKL analyzed data. MH interpreted the results and wrote the manuscript. RS, JL, BG, and PR interpreted the results and reviewed the manuscript.
Disclosure statement
GB has received honoraria for consulting services by Karyopharm Therapeutics, MJH, Pfizer, and Clearview. PGR reports serving on advisory committees for Karyopharm, Oncopeptides, Celgene, a Bristol Myers Squibb Company, Takeda, Amgen, and Jazz Pharmaceuticals. The remaining authors declare no competing financial interests.