New Biomarkers of Ferric Management in Multiple Myeloma and Kidney Disease-Associated Anemia

Abstract

Multiple myeloma (MM) is a malignancy of clonal plasma cells accounting for approximately 10% of haematological malignancies. MM mainly affects older patients, more often males and is more frequently seen in African Americans. The most frequent manifestations of MM are anaemia, osteolytic bone lesions, kidney failure and hypercalcemia. The anaemia develops secondary to suppression of erythropoiesis by cytokine networks, similarly to the mechanism of anaemia of chronic disease. The concomitant presence of kidney failure, especially chronic kidney disease (CKD) and MM per se, leading to anaemia of chronic disease (ACD) in combination, provoked us to pose the question about their reciprocal dependence and relationship with specific biomarkers; namely, soluble transferrin receptor (sTfR), growth differentiation factor 15 (GDF15), hepcidin 25 and zonulin. One or more of these are new biomarkers of ferric management may be utilized in the near future as prognostic predictors for patients with MM and kidney failure.

High Carbohydrate Diet Is Associated with Severe Clinical Indicators, but Not with Nutrition Knowledge Score in Patients with Multiple Myeloma

“…Considering that most MM patients are elderly, the clinical aspects previously presented may be even more important [36]. Anemia is often associated with and aggravated by chronic kidney disease [37].…”

Associations Between Cardiac Biomarkers and Cardiac Structure and Function in CKD

“…Additionally, because there was a 1-year time lag between biomarker and echocardiographic measurements, it is possible that we missed associations that would have been observed had they been measured simultaneously. Previous studies have reported possible associations with GDF-15 and anemia [49][50][51][52][53][54][55] ; however, we did not have detailed information on iron stores or other measures of anemia to fully evaluate this association in the present study. This was an observational study, so we cannot determine causality.…”

Renal Impairment Detectors: IGFBP-7 and NGAL as Tubular Injury Markers in Multiple Myeloma Patients

“…Expression in the renal tissue may hold a relationship with primary disease (e.g., diabetic nephropathy) and is under investigation [30,31]. Although certain biomarkers can be conveniently extrapolated based on their utility in the general population, validation in diseases with a distinct mechanism of kidney injury is necessary [32].…”