title: Restoration of renal function in patients with newly diagnosed multiple myeloma is not associated with improved survival: a population-based study.
abstract: Renal impairment (RI) in patients with multiple myeloma (MM) is associated with poor prognosis. In this population-based cohort study, we assessed the effects of renal response, evaluated according to the IMWG-criteria, on overall survival (OS) in patients with newly diagnosed MM with RI at presentation. All included patients were diagnosed between January 2005 and January 2014 with MM and RI in Friesland, a province of the Netherlands. Of the 131 included patients, 61% achieved renal response. Using a time-varying exposure Cox model, no difference in OS between renal response and non-response was observed (HR = 1.08, 95% CI = 0.67-1.74, p = .76). In multivariable analysis, baseline eGFR <30 ml/min (HR = 1.71), age >70 yrs (HR = 1.77), hypercalcemia (HR = 2.73), lambda Bence-Jones (HR= 1.76), and initial treatment regimen (HR = 0.89 for thalidomide, HR = 1.95 in treatment regimens without novel agents and HR = 3.60 for no chemotherapy, all vs. bortezomib) were associated with decreased OS. In conclusion, achieving renal response was not associated with improved OS.
authors.affiliation: a Department of Hematology , Medical Centre Leeuwarden , Leeuwarden , The Netherlands.
authors.forename: Joost C
authors.initials: JC
authors.lastname: de Vries
authors.affiliation: b Department of Clinical Pharmacy & Pharmacology , Medical Center Leeuwarden , Leeuwarden , The Netherlands.
authors.forename: Berdien
authors.initials: B
authors.lastname: Oortgiesen
authors.affiliation: c Department of Nephrology , Medical Centre Leeuwarden , Leeuwarden , The Netherlands.
authors.forename: Marc H
authors.initials: MH
authors.lastname: Hemmelder
authors.affiliation: b Department of Clinical Pharmacy & Pharmacology , Medical Center Leeuwarden , Leeuwarden , The Netherlands.
authors.forename: Eric
authors.initials: E
authors.lastname: van Roon
authors.affiliation: d Department of Pathology , Pathology Friesland , Leeuwarden , The Netherlands.
authors.forename: Robby E
authors.initials: RE
authors.lastname: Kibbelaar
authors.affiliation: e Department of Epidemiology , MCL Academy , Leeuwarden , The Netherlands.
authors.forename: Nic
authors.initials: N
authors.lastname: Veeger
authors.affiliation: a Department of Hematology , Medical Centre Leeuwarden , Leeuwarden , The Netherlands.
authors.forename: Mels
authors.initials: M
authors.lastname: Hoogendoorn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D053208:Kaplan-Meier Estimate; D007674:Kidney Diseases / Q000453:epidemiology / Q000209:etiology; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality*; D011159:Population Surveillance; D011379:Prognosis; D012307:Risk Factors
keywords: Multiple myeloma; dialysis; novel treatment; overall survival; renal impairment; renal response