title: High-dose intravenous melphalan in a patient with multiple myeloma and oliguric renal failure.
abstract: A kappa light-chain myeloma was diagnosed as the underlying disease in a 52-year-old woman with acute oliguric renal failure. The patient was erroneously treated with high-dose intravenous melphalan (60 mg/m2). Because of this overdose treatment with granulocyte colony-stimulating factor was initiated, but pronounced absolute leukopenia (white blood cell count < 0.5 x 10(9)/l) developed and lasted for 13 days. Following melphalan treatment a continuous increase in urine volume was accompanied by a decrease of serum creatinine and blood urea nitrogen. Within 10 days after the administration of melphalan the patient no longer required hemodialysis. We conclude that high-dose chemotherapy in combination with hematopoietic growth factors should be considered in individual cases with newly diagnosed light-chain nephropathy.
authors.affiliation: I. Medizinische Abteilung mit Onkologie, Wilhelminenspital, Wien, Austria.
authors.forename: M
authors.initials: M
authors.lastname: Pecherstorfer
authors.forename: I
authors.initials: I
authors.lastname: Zimmer-Roth
authors.forename: S
authors.initials: S
authors.lastname: Weidinger
authors.forename: K
authors.initials: K
authors.lastname: Irsigler
authors.forename: W M
authors.initials: WM
authors.lastname: Halbmayer
authors.forename: W
authors.initials: W
authors.lastname: Ulrich
authors.forename: M
authors.initials: M
authors.lastname: Fischer
authors.forename: G
authors.initials: G
authors.lastname: Baumgartner
mesh_terms: D058186:Acute Kidney Injury / Q000150:complications / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D062787:Drug Overdose; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008558:Melphalan / Q000008:administration & dosage*; D008875:Middle Aged; D009101:Multiple Myeloma / Q000188:drug therapy*; D009846:Oliguria / Q000188:drug therapy* / Q000209:etiology; D006435:Renal Dialysis
chemical_list: D008558:Melphalan