title: Outcome of patients with multiple myeloma and renal failure on novel regimens.
abstract: Renal involvement occurs in 20-40% of newly diagnosed multiple myeloma (MM) patients, and diagnosis of myeloma is frequently made after investigation for unexplained renal disease. This is a retrospective study between 2006 and 2013 in which 57 consecutive patients seen at the Nephrology Unit with diagnosis of MM were enrolled. MM was diagnosed for the first time because of renal dysfunction and/or proteinuria in these patients. The mean age of the patients (65% male) was 58.3 ± 12.7 years. The median baseline serum creatinine was 3.5 mg/dL (1.4-14.5). Anemia (hemoglobin <12 g/dL) was noted in 88% and hypercalcemia (calcium >10.5 mg/dL) in 35% of patients. Early hemodialysis was started in 28 patients (49%). Thalidomide plus dexamethasone (16% on bortezomib) were the main therapeutic regimens. Three patients (5%) underwent autologous stem cell transplantation. Twenty-six patients (45.6%) died during a median follow-up of 25 months (1-90). The mean age of patients who died was significantly higher than the age in patients who were alive (62.2 ± 12.7 vs. 55.2 ± 11.9 years, respectively; P = 0.037). Early hemodialysis had no significant effect on mortality rate. The one-, three and five year patient survival was 71%, 54%, and 41%, respectively. The median overall survival of patients was 50 months. Prolonged patient survival can be expected in myeloma patients with renal failure or on dialysis by applying novel therapeutic agents.
authors.affiliation: Nephrology Department, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Tayebeh
authors.initials: T
authors.lastname: Soleymanian
authors.forename: Adel
authors.initials: A
authors.lastname: Soleimani
authors.forename: Asadollah
authors.initials: A
authors.lastname: Musavi
authors.forename: Kourosh
authors.initials: K
authors.lastname: Mojtahedi
authors.forename: Gholamreza
authors.initials: G
authors.lastname: Hamid
mesh_terms: D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D000069286:Bortezomib / Q000008:administration & dosage; D003907:Dexamethasone / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007492:Iran; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D016016:Proportional Hazards Models; D006435:Renal Dialysis; D051437:Renal Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D012189:Retrospective Studies; D012307:Risk Factors; D033581:Stem Cell Transplantation; D013792:Thalidomide / Q000008:administration & dosage; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D013792:Thalidomide; D000069286:Bortezomib; D003907:Dexamethasone