Plasma exchange for myeloma kidney: cast(s) away?
Leung et al. (this issue) present a retrospective study of 40 patients. Observations in 14/40 led to the suggestion of restitution of plasma exchange for light-chain responsive, biopsy-proven myeloma kidney until a better randomized control trial (RCT) is constructed. A careful analysis of their study and a recent RCT suggest little difference in outcome between plasma exchange and control groups. The analysis supports restitution of a better RCT of plasma exchange for myeloma kidney rather than off-label use.
Clark
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WF
Division of Nephrology, University of Western Ontario, London, Ontario, Canada. william.clark@lhsc.on.ca
Garg
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AX
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy*; D010951:Plasma Exchange