Renal impairment in patients with multiple myeloma: a consensus statement on behalf of the International Myeloma Working Group.
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Renal impairment in patients with multiple myeloma: a consensus statement on behalf of the International Myeloma Working Group. / Dimopoulos, Meletios A; Terpos, Evangelos; Chanan-Khan, Asher; Leung, Nelson; Ludwig, Heinz; Jagannath, Sundar; Niesvizky, Ruben; Giralt, Sergio; Fermand, Jean-Paul; Bladé, Joan; Comenzo, Raymond L; Sezer, Orhan; Palumbo, Antonio; Harousseau, Jean-Luc; Richardson, Paul G; Barlogie, Bart; Anderson, Kenneth C; Sonneveld, Pieter; Tosi, Patrizia; Cavo, Michele; Rajkumar, S Vincent; Durie, Brian G M; Jésus, San Miguel.
In: J CLIN ONCOL, Vol. 28, No. 33, 33, 2010, p. 4976-4984.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Renal impairment in patients with multiple myeloma: a consensus statement on behalf of the International Myeloma Working Group.
AU - Dimopoulos, Meletios A
AU - Terpos, Evangelos
AU - Chanan-Khan, Asher
AU - Leung, Nelson
AU - Ludwig, Heinz
AU - Jagannath, Sundar
AU - Niesvizky, Ruben
AU - Giralt, Sergio
AU - Fermand, Jean-Paul
AU - Bladé, Joan
AU - Comenzo, Raymond L
AU - Sezer, Orhan
AU - Palumbo, Antonio
AU - Harousseau, Jean-Luc
AU - Richardson, Paul G
AU - Barlogie, Bart
AU - Anderson, Kenneth C
AU - Sonneveld, Pieter
AU - Tosi, Patrizia
AU - Cavo, Michele
AU - Rajkumar, S Vincent
AU - Durie, Brian G M
AU - Jésus, San Miguel
PY - 2010
Y1 - 2010
N2 - Renal impairment is a common complication of multiple myeloma (MM). The estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease formula is the recommended method for the assessment of renal function in patients with MM with stabilized serum creatinine. In acute renal injury, the RIFLE (risk, injury, failure, loss and end-stage kidney disease) and Acute Renal Injury Network criteria seem to be appropriate to define the severity of renal impairment. Novel criteria based on eGFR measurements are recommended for the definition of the reversibility of renal impairment. Rapid intervention to reverse renal dysfunction is critical for the management of these patients, especially for those with light chain cast nephropathy. Bortezomib with high-dose dexamethasone is considered as the treatment of choice for such patients. There is limited experience with thalidomide in patients with myeloma with renal impairment. Thus, thalidomide can be carefully administered, mainly in the context of well-designed clinical trials, to evaluate if it can improve the rapidity and probability of response that is produced by the combination with bortezomib and high-dose dexamethasone. Lenalidomide is effective in this setting and can reverse renal insufficiency in a significant subset of patients, when it is given at reduced doses, according to renal function. The role of plasma exchange in patients with suspected light chain cast nephropathy and renal impairment is controversial. High-dose melphalan (140 mg/m(2)) and autologous stem-cell transplantation should be limited to younger patients with chemosensitive disease.
AB - Renal impairment is a common complication of multiple myeloma (MM). The estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease formula is the recommended method for the assessment of renal function in patients with MM with stabilized serum creatinine. In acute renal injury, the RIFLE (risk, injury, failure, loss and end-stage kidney disease) and Acute Renal Injury Network criteria seem to be appropriate to define the severity of renal impairment. Novel criteria based on eGFR measurements are recommended for the definition of the reversibility of renal impairment. Rapid intervention to reverse renal dysfunction is critical for the management of these patients, especially for those with light chain cast nephropathy. Bortezomib with high-dose dexamethasone is considered as the treatment of choice for such patients. There is limited experience with thalidomide in patients with myeloma with renal impairment. Thus, thalidomide can be carefully administered, mainly in the context of well-designed clinical trials, to evaluate if it can improve the rapidity and probability of response that is produced by the combination with bortezomib and high-dose dexamethasone. Lenalidomide is effective in this setting and can reverse renal insufficiency in a significant subset of patients, when it is given at reduced doses, according to renal function. The role of plasma exchange in patients with suspected light chain cast nephropathy and renal impairment is controversial. High-dose melphalan (140 mg/m(2)) and autologous stem-cell transplantation should be limited to younger patients with chemosensitive disease.
KW - Humans
KW - Prognosis
KW - Incidence
KW - Hematopoietic Stem Cell Transplantation
KW - Transplantation, Autologous
KW - Boronic Acids therapeutic use
KW - Glomerular Filtration Rate
KW - Melphalan therapeutic use
KW - Multiple Myeloma complications
KW - Pyrazines therapeutic use
KW - Renal Insufficiency epidemiology
KW - Thalidomide therapeutic use
KW - Humans
KW - Prognosis
KW - Incidence
KW - Hematopoietic Stem Cell Transplantation
KW - Transplantation, Autologous
KW - Boronic Acids therapeutic use
KW - Glomerular Filtration Rate
KW - Melphalan therapeutic use
KW - Multiple Myeloma complications
KW - Pyrazines therapeutic use
KW - Renal Insufficiency epidemiology
KW - Thalidomide therapeutic use
M3 - SCORING: Zeitschriftenaufsatz
VL - 28
SP - 4976
EP - 4984
JO - J CLIN ONCOL
JF - J CLIN ONCOL
SN - 0732-183X
IS - 33
M1 - 33
ER -
