Outcomes of newly diagnosed myeloma patients requiring dialysis: renal recovery, importance of rapid response and survival benefit

Dimopoulos, Meletios A.; Ρούσσου, Μαρία; Gavriatopoulou, Maria; Fotiou, Despina; Ziogas, Dimitrios C.; Migkou, Magdalini; Panagiotidis, Ioannis; Eleutherakis‐Papaiakovou, Evangelos; Kanellias, Nikos; Psimenou, Erasmia; Marinaki, Smaragdi; Bacharaki, Dimitra; Mparmparoussi, Despoina; Matsouka, Charis; Giannouli, Stavroula; Terpos, Evangelos; Kastritis, Efstathios

doi:10.1038/bcj.2017.49

Cited by 34 publications

(29 citation statements)

References 15 publications

(20 reference statements)

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“…3,31 In the meantime, Dimopoulos et al suggest that very high levels of FLCs were associated with a lower probability of RF recovery or dialysis discontinuation. 12,13 Inaconclusion,ourdataindicatethattheshorterkidneydisease history, lower serum level of β2-microglobulin and free light chain, achieving at least VGPR is related to a high probability of hemodialysis discontinuation and bortezomib-based regimens were strongly recommended for treatment of MM patients requiring dialysis. In addition, recovery from dialysis dependence, proteinuria <3.5 g/24 h, and achieving at least VGPR can lead to enormous survival benefits in NDMM patients with serious renal impairment requiring hemodialysis.…”

Section: Itisknowntousthatserumflcassaysindiagnosticscreen-mentioning

confidence: 79%

“…Renal failure is related to a growth risk of early death and treatment‐related toxicity . Many studies have confirmed that renal failure and reversal of hemodialysis dependence can lead to enormous survival benefits . However, the effect factors of recovery from renal impairment and reversal of hemodialysis dependence are unknown.…”

Section: Discussionmentioning

confidence: 99%

“…In the meanwhile, the other study from the group of Dimopoulos has recently investigated the outcomes of 52 NDMM patients requiring dialysis . Early mortality (within 2 months from start of therapy) was 16%, in most cases because of infectious complications.…”

Section: Discussionmentioning

confidence: 99%

“…2 Many studies have confirmed that renal failure and reversal of hemodialysis dependence can lead to enormous survival benefits. 5,11,12 Many studies have confirmed that bortezomib-based therapy was very effective for the treatment of MM patients with renal failure [14][15][16][17][18] and could reverse dialysis dependence. 10,19 In our study, at least VGPR rate was 46.88% in patients received bortezomib-based therapy, and 23.08% for those treated with thalidomide-based com- 20,21 It is essential to be able to recognize the symptoms of myeloma in clinical routine and to be aware of basic diagnostic features to confirm this disease and give timely treatment.…”

Section: Discussionmentioning

confidence: 99%

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Effect factors related to a high probability of hemodialysis independence in newly diagnosed multiple myeloma patients requiring hemodialysis

Song

Jiang

Liu

et al. 2019

Clinical Laboratory Analysis

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Background Renal failure is a severe complication of symptomatic myeloma, related to higher mortality. Recovery from dialysis dependence can lead to enormous survival benefits. We investigated the effect factors for probability of dialysis independence. Methods Retrospective data on 45 newly diagnosed MM (NDMM) patients with serious renal impairment and requiring hemodialysis were analyzed. The statistical methods including logistic regression analysis, Kaplan‐Meier survival curves, the log‐rank test and the Cox proportional hazards model for survival analysis were used in our study. Results Twenty‐two of the 45 patients, who were on hemodialysis at diagnosis, became dialysis independence. In the logistic regression analysis, serum level of β2‐microglobulin, kidney disease history, involved free light chain, and achieving at least VGPR were significantly associated with reversibility from dialysis dependence. In addition, achieving hemodialysis discontinuation was related to better survival. The multivariate analyses demonstrated that reversibility from dialysis dependence, proteinuria < 3.5 g/24 h, and achieving at least VGPR were significantly associated with OS among NDMM patients requiring hemodialysis. Conclusion Lower serum level of β2‐microglobulin and lower level of free light chain at diagnosis, achieving at least VGPR, and shorter kidney disease history are related to a high probability of dialysis independence in NDMM patients with serious renal failure requiring dialysis.

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Section: Itisknowntousthatserumflcassaysindiagnosticscreen-mentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Effect factors related to a high probability of hemodialysis independence in newly diagnosed multiple myeloma patients requiring hemodialysis

Song

Jiang

Liu

et al. 2019

Clinical Laboratory Analysis

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“…However, recent studies using novel agents, particularly bortezomib, reported a 44% RRT independence rate from 2008 to 2014 17 . In 2017, Dimopoulos et al reported 49% independence of RRT in their cohort of 52 patients 18 . The increase in RRT independence and survival in recent years is probably explained by the increased use of bortezomib, which was not available in our center at the time of the study.…”

Section: Discussionmentioning

confidence: 99%

Prognostic impact of renal failure recovery in patients with newly diagnosed multiple mieloma

et al. 2019

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Background: Renal failure (RF) is a common complication in patients with newly diagnosed multiple myeloma (NDMM). Aim: To evaluate the frequency of RF in NDMM patients, and the prognostic impact of its reversibility. Material and Methods: A retrospective study evaluating demographic and clinical characteristics of 154 consecutive patients with NDMM was carried out. Estimated glomerular filtration rate (eGFR) was calculated at the beginning and at the end of the induction therapy. In addition, we evaluated renal responses (RR) according to the International Myeloma Working Group (IMWG) criteria. The induction regimen was based on thalidomide in all cases. Results: Fifty-three patients had RF (34.4%). Complete renal response (RR) was achieved in 51%. Three years overall survival in patients without RF, with RF and complete RR, and patients with RF and any other RR, was 66, 47 and 13%, respectively. Median survival was 53, 27 and 6 months, respectively (p < 0.01). In the multivariate analysis, RF and hypercalcemia were independent predictors of a worse outcome. Conclusions: Achieving a complete RR in patients with NDMM, is associated with a better survival. (Rev Med Chile 2019; 147: 1374-1381 Impacto pronóstico de remisión renal en pacientes con mieloma múltiple de reciente diagnóstico Antecedentes: La falla renal (FR) es una complicación frecuente en pacientes con mieloma múltiple (MM). Objetivo: Evaluar la frecuencia de FR en pacientes con reciente diagnóstico de MM y determinar la importancia pronóstica de su reversibilidad. Material y Métodos: Se realizó un estudio retrospectivo de 154 pacientes consecutivos con MM. La función renal se evaluó mediante la tasa estimada de filtración glomerular al inicio y final de la terapia de inducción. Además, evaluamos las respuestas renales (RR) de acuerdo con los criterios del International Myeloma Working Group (IMWG). El régimen de inducción se basó en talidomida en todos los casos. Resultados: Cincuenta y tres pacientes presentaron FR (34,4%) al diagnóstico. La RR completa se logró en 51%. La sobrevida global (SG) a 3 años en pacientes sin FR, con FR y RR completa, y

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Plasma Cell Disorders

Yee¹,

Hideshima²,

Raje³

et al. 2022

Holland‐Frei Cancer Medicine

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Overview Plasma cell disorders have in common a proliferation of monoclonal plasma cells associated with the production of a monoclonal protein. These disorders range from the common, indolent condition of monoclonal gammopathy of undetermined significance to malignancies such as multiple myeloma characterized by the presence of hypercalcemia, anemia, renal dysfunction, and/or lytic bone lesions. Progress in the understanding of the molecular underpinnings of myeloma has led to remarkable advances in its treatment. High‐dose melphalan and autologous stem cell transplant have been a mainstay of treatment. Now, highly effective and well‐tolerated drug classes such as the proteasome inhibitors (e.g., bortezomib, carfilzomib), immunomodulatory drugs (e.g., lenalidomide, pomalidomide), and anti‐CD38 monoclonal antibodies (e.g., daratumumab, isatuximab) have rapidly transformed treatment and significantly improved overall survival. Newer therapies targeting B‐cell maturation antigen (BCMA) have the potential to further improve outcomes.

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Outcomes of newly diagnosed myeloma patients requiring dialysis: renal recovery, importance of rapid response and survival benefit

Cited by 34 publications

References 15 publications

Effect factors related to a high probability of hemodialysis independence in newly diagnosed multiple myeloma patients requiring hemodialysis

Effect factors related to a high probability of hemodialysis independence in newly diagnosed multiple myeloma patients requiring hemodialysis

Prognostic impact of renal failure recovery in patients with newly diagnosed multiple mieloma

Plasma Cell Disorders

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