title: [Clinical feature and efficacy of patients with multiple myeloma and renal impairment treated with bortezomib based chemotherapy].
abstract: OBJECTIVE
  To explore the efficacy and safety of bortezomib (btz) based chemotherapy in multiple myeloma (MM) patients with renal-function impairment (RI).
  
  
  METHODS
  Fifty-six MM patients with impaired renal function treated with bortazomib based regimens in our single center were retrospectively analyzed.
  
  
  RESULTS
  The median age was 59 (ranged 30-77) years. 39.3% were κ-restricted MM, while 57.1% were λ-restricted MM. Nine patients were IgD-MM, and 14 were light chain MM. Median creatinine clearance (CrCl) was 25.33 (7.23-59.55) ml/min. The number of patients with mild, moderate and severe RI was 6, 35 and 15, respectively. Overall response rate of MM was 82.4% (≥MR), including 32.4% complete response (CR), 17.6% very good partial response (VGPR) and 26.5% partial response (PR). The rate of renal response was 89.3%, including 62.5% CR, 14.3% PR and 12.5% minor response (MR). A median time of optimal response was 25.5 (ranged 5-240) days. There was no significant difference in the median overall survival and the time to progress in different RI groups. Adverse events observed were similar to those patients with normal renal function previously reported. Most adverse events were manageable, 55.6% patients developed peripheral neuropathy and 10 patients discontinued bortezomib.
  
  
  CONCLUSIONS
  The incidence of RI is higher in patients with IgD-MM and λ restricted MM. Bortezomib based treatment is a highly effective and safe option in MM patients with impaired renal function. In this analysis, renal function was improved in a substantial proportion of patients. Peripheral neuropathy is the major adverse events which limit its use in MM patients.
authors.affiliation: Institute of Hematology & Blood Diseases Hospital, CAMS & PUMC, Tianjin, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Xu
authors.forename: Gang
authors.initials: G
authors.lastname: An
authors.forename: Shu-hui
authors.initials: SH
authors.lastname: Deng
authors.forename: Wei-wei
authors.initials: WW
authors.lastname: Sui
authors.forename: Xiao-yan
authors.initials: XY
authors.lastname: Feng
authors.forename: Fei
authors.initials: F
authors.lastname: Li
authors.forename: Mu
authors.initials: M
authors.lastname: Hao
authors.forename: Ya-fei
authors.initials: YF
authors.lastname: Wang
authors.forename: Lu-gui
authors.initials: LG
authors.lastname: Qiu
mesh_terms: D000328:Adult; D000368:Aged; D001897:Boronic Acids / Q000627:therapeutic use*; D000069286:Bortezomib; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000188:drug therapy*; D011719:Pyrazines / Q000627:therapeutic use*; D051437:Renal Insufficiency / Q000209:etiology; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D001897:Boronic Acids; D011719:Pyrazines; D000069286:Bortezomib