Skip to main content
Erschienen in: memo - Magazine of European Medical Oncology 3/2017

21.08.2017 | review

Renal insufficiency in patients with multiple myeloma

verfasst von: Dr. Boris Bozic, Dr. Sophie Hölbling, Dr. Vanessa Völkel, Prim. Prof. Dr. Christian Sebesta

Erschienen in: memo - Magazine of European Medical Oncology | Ausgabe 3/2017

Einloggen, um Zugang zu erhalten

Summary

Renal insufficiency in patients with multiple myeloma represents a major challenge for the treating physician. In patients with etiologically unclear renal failure it is important to consider multiple myeloma as a possible cause of such renal failure. The diagnosis and treatment of these patients is interdisciplinary, in cooperation with hemato-oncologists, radiologists, nephrologists and intensive care specialists. The main goal of all treatment methods is the rapid reduction of pathological free light chains in the serum, resulting in an improvement of renal function. Equally important is the avoidance of nephrotoxic drugs and iodinated contrast agents in patients with renal insufficiency and multiple myeloma. A few new drugs have been used in the systemic treatment of patients with multiple myeloma (MM) and renal failure with much success, especially the beneficial use of pomalidomide is interesting and other drugs will follow soon.
Literatur
1.
Zurück zum Zitat Badros AZ, Vij R, Martin T, Zonder JA, et al. Carfilzomib in multiple myeloma patients with renal impairment: Pharmacokinetics and safety. Leukemia. 2013;27:1707–14.CrossRefPubMedPubMedCentral Badros AZ, Vij R, Martin T, Zonder JA, et al. Carfilzomib in multiple myeloma patients with renal impairment: Pharmacokinetics and safety. Leukemia. 2013;27:1707–14.CrossRefPubMedPubMedCentral
2.
Zurück zum Zitat Baz RC, Martin TG 3rd, Lin HY, et al. Randomized multicenter phase II study of pomalidomide, cyclophosphamide, and dexamethasone in relapsed refractory myeloma. Blood. 2016 May 26;127(21):2561–8-CrossRefPubMed Baz RC, Martin TG 3rd, Lin HY, et al. Randomized multicenter phase II study of pomalidomide, cyclophosphamide, and dexamethasone in relapsed refractory myeloma. Blood. 2016 May 26;127(21):2561–8-CrossRefPubMed
3.
Zurück zum Zitat Benboubker L, Dimopoulos MA, Dispenzieri A, Catalano J, Belch AR, Cavo M. Lenalidomide and dexamethasone in transplant-ineligible patients with myeloma. N Engl J Med. 2014;371:906–17.CrossRefPubMed Benboubker L, Dimopoulos MA, Dispenzieri A, Catalano J, Belch AR, Cavo M. Lenalidomide and dexamethasone in transplant-ineligible patients with myeloma. N Engl J Med. 2014;371:906–17.CrossRefPubMed
4.
Zurück zum Zitat Berdeja J. Pharmacokinetics and safety of Elotuzumab combined with Lenalidomide and Dexamethasone in patients with multiple myeloma and various levels of renal impairment: Results of a phase Ib study. Clin Lymphoma Myeloma Leuk. 2016;16(3):129–38.CrossRefPubMed Berdeja J. Pharmacokinetics and safety of Elotuzumab combined with Lenalidomide and Dexamethasone in patients with multiple myeloma and various levels of renal impairment: Results of a phase Ib study. Clin Lymphoma Myeloma Leuk. 2016;16(3):129–38.CrossRefPubMed
5.
Zurück zum Zitat Bridoux F, Pegourie B, Meunier KA, Royer B, Joly B, Lamy T, Kolb B, Benboubker L, Arnulf B, Jaccard A, Chevret S, Fermand JP. Treatment of myeloma cast Nephropathy (MCN): A randomized trial comparing intensive Haemodialysis (HD) with high cut-off (HCO) or standard high-flux dialyzer in patients receiving a Bortezomib-based regimen (the MYRE study, by the Intergroupe Francophone du Myélome (IFM) and the french society of Nephrology (SFNDT)). Blood. 2016;128(22):978. Bridoux F, Pegourie B, Meunier KA, Royer B, Joly B, Lamy T, Kolb B, Benboubker L, Arnulf B, Jaccard A, Chevret S, Fermand JP. Treatment of myeloma cast Nephropathy (MCN): A randomized trial comparing intensive Haemodialysis (HD) with high cut-off (HCO) or standard high-flux dialyzer in patients receiving a Bortezomib-based regimen (the MYRE study, by the Intergroupe Francophone du Myélome (IFM) and the french society of Nephrology (SFNDT)). Blood. 2016;128(22):978.
6.
Zurück zum Zitat Davenport A, Merlini G. Myeloma kidney: advances in molecular mechanisms of acute kidney injury open novel therapeutic opportunities. Nephrol Dial Transplant. 2012;27:3713–8.CrossRefPubMed Davenport A, Merlini G. Myeloma kidney: advances in molecular mechanisms of acute kidney injury open novel therapeutic opportunities. Nephrol Dial Transplant. 2012;27:3713–8.CrossRefPubMed
7.
Zurück zum Zitat Dimopoulos MA, et al. International myeloma working group recommendations for the diagnosis and management of myeloma-related renal impairment. J Clin Oncol. 2016;34:1.CrossRef Dimopoulos MA, et al. International myeloma working group recommendations for the diagnosis and management of myeloma-related renal impairment. J Clin Oncol. 2016;34:1.CrossRef
8.
Zurück zum Zitat Dimopoulos MA, Roussou M, et al. Cardiac and renal complications of carfilzomib in patients with multiple myeloma. Bloodadvances. 2017;7:449–54. Dimopoulos MA, Roussou M, et al. Cardiac and renal complications of carfilzomib in patients with multiple myeloma. Bloodadvances. 2017;7:449–54.
9.
Zurück zum Zitat Dimopoulos M, Kyle R, Fermand JP, Rajkumar SV, San Miguel J, Chanan-Khan A, et al. Consensus recommendations for standard investigative workup: Report of the International Myeloma Workshop Consensus Panel 3. Blood. 2011;117(18):4701–5.CrossRefPubMed Dimopoulos M, Kyle R, Fermand JP, Rajkumar SV, San Miguel J, Chanan-Khan A, et al. Consensus recommendations for standard investigative workup: Report of the International Myeloma Workshop Consensus Panel 3. Blood. 2011;117(18):4701–5.CrossRefPubMed
10.
Zurück zum Zitat Dimopoulos MA, Kastritis E, Rosinol L, Bladé J, Ludwig H. Pathogenesis and treatment of renal failure in multiple myeloma. Leukemia. 2008;22:1485–93.CrossRefPubMed Dimopoulos MA, Kastritis E, Rosinol L, Bladé J, Ludwig H. Pathogenesis and treatment of renal failure in multiple myeloma. Leukemia. 2008;22:1485–93.CrossRefPubMed
11.
Zurück zum Zitat Dimopoulos MA, Delimpasi S, Katodritou E, Vassou A, et al. Significant improvement in the survival of patients with multiple myeloma presenting with severe renal impairment after the introduction of novel agents. Ann Oncol. 2014;25:195–200.CrossRefPubMed Dimopoulos MA, Delimpasi S, Katodritou E, Vassou A, et al. Significant improvement in the survival of patients with multiple myeloma presenting with severe renal impairment after the introduction of novel agents. Ann Oncol. 2014;25:195–200.CrossRefPubMed
12.
Zurück zum Zitat Dimopoulos MA, Leleu X, Palumbo A, Moreau P, Delforge M, Cavo M, Ludwig H. Expert panel consensus statement on the optimal use of pomalidomide in relapsed and refractory multiple myeloma. Leukemia. 2014;28:1573–85.CrossRefPubMedPubMedCentral Dimopoulos MA, Leleu X, Palumbo A, Moreau P, Delforge M, Cavo M, Ludwig H. Expert panel consensus statement on the optimal use of pomalidomide in relapsed and refractory multiple myeloma. Leukemia. 2014;28:1573–85.CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Dimopoulos MA, Oriol A, Nahi H, San-Miguel J, et al. Daratumumab, Lenalidomide, and Dexamethasone for multiple myeloma. N Engl J Med. 2016;375:1319–31.CrossRefPubMed Dimopoulos MA, Oriol A, Nahi H, San-Miguel J, et al. Daratumumab, Lenalidomide, and Dexamethasone for multiple myeloma. N Engl J Med. 2016;375:1319–31.CrossRefPubMed
14.
Zurück zum Zitat Dispenzieri A, Kyle R, Merlini G, Miguel JS, Ludwig H, et al. International Myeloma Working Group guidelines for serum-free light chain analysis in multiple myeloma and related disorders. Leukemia. 2009;23:215–24.CrossRefPubMed Dispenzieri A, Kyle R, Merlini G, Miguel JS, Ludwig H, et al. International Myeloma Working Group guidelines for serum-free light chain analysis in multiple myeloma and related disorders. Leukemia. 2009;23:215–24.CrossRefPubMed
15.
Zurück zum Zitat Engelhardt M, Terpos E, Kleber M, et al. European Myeloma Network recommendations on the evaluation and treatment of newly diagnosed patients with multiple myeloma. Haematologica. 2014;99(2):232–42.CrossRefPubMedPubMedCentral Engelhardt M, Terpos E, Kleber M, et al. European Myeloma Network recommendations on the evaluation and treatment of newly diagnosed patients with multiple myeloma. Haematologica. 2014;99(2):232–42.CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Gupta N, et al. A pharmacokinetics and safety phase 1/1b study of oral ixazomib in patients with multiple myeloma and severe renal impairment or end-stage renal disease requiring haemodialysis. Br J Haematol. 2016;174(5):748–59.CrossRefPubMedPubMedCentral Gupta N, et al. A pharmacokinetics and safety phase 1/1b study of oral ixazomib in patients with multiple myeloma and severe renal impairment or end-stage renal disease requiring haemodialysis. Br J Haematol. 2016;174(5):748–59.CrossRefPubMedPubMedCentral
17.
Zurück zum Zitat Hutschison CA, Cook M, Heyne N, Weisel K, Billingham L, Bradwell A, Cockwell P. European trial of free light chain removal by extended haemodialysis in cast nephropathy (EuLITE): A randomised control trial. Trials. 2008;9:55.CrossRef Hutschison CA, Cook M, Heyne N, Weisel K, Billingham L, Bradwell A, Cockwell P. European trial of free light chain removal by extended haemodialysis in cast nephropathy (EuLITE): A randomised control trial. Trials. 2008;9:55.CrossRef
18.
Zurück zum Zitat Larocca A, Montefusco V, Bringhen S, et al. Pomalidomide, cyclophosphamide, and prednisone for relapsed/refractory multiple myeloma: A multicenter phase 1/2 open-label study. Blood. 2013;122(16):2799–806.CrossRefPubMed Larocca A, Montefusco V, Bringhen S, et al. Pomalidomide, cyclophosphamide, and prednisone for relapsed/refractory multiple myeloma: A multicenter phase 1/2 open-label study. Blood. 2013;122(16):2799–806.CrossRefPubMed
19.
Zurück zum Zitat Lee CK, Zangari M, Barlogie B, Fassas A, van Rhee F, Thertulien R, et al. Dialysis-dependent renal failure in patients with myeloma can be reversed by high-dose myeloablative therapy and autotransplant. Bone Marrow Transplant. 2004;33:823–8.CrossRefPubMed Lee CK, Zangari M, Barlogie B, Fassas A, van Rhee F, Thertulien R, et al. Dialysis-dependent renal failure in patients with myeloma can be reversed by high-dose myeloablative therapy and autotransplant. Bone Marrow Transplant. 2004;33:823–8.CrossRefPubMed
21.
Zurück zum Zitat Ludwig H, Drach J, Graf H, Lang A, Meran JG, et al. Reversal of acute renal failure by bortezomib-based chemotherapy in patients with multiple myeloma. Haematologica. 2007;92:1411–4.CrossRefPubMed Ludwig H, Drach J, Graf H, Lang A, Meran JG, et al. Reversal of acute renal failure by bortezomib-based chemotherapy in patients with multiple myeloma. Haematologica. 2007;92:1411–4.CrossRefPubMed
22.
Zurück zum Zitat Ludwig H, Adam Z, Hajek R, et al. Light chain–induced acute renal failure Can be reversed by Bortezomib-Doxorubicin-Dexamethasone in multiple myeloma: Results of a phase II study. J Clin Oncol. 2010;28:4635–41.CrossRefPubMed Ludwig H, Adam Z, Hajek R, et al. Light chain–induced acute renal failure Can be reversed by Bortezomib-Doxorubicin-Dexamethasone in multiple myeloma: Results of a phase II study. J Clin Oncol. 2010;28:4635–41.CrossRefPubMed
23.
Zurück zum Zitat Ludwig H, Miguel JS, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group recommendations for global myeloma care. Leukemia. 2014;28:981–92.CrossRefPubMed Ludwig H, Miguel JS, Dimopoulos MA, Palumbo A, et al. International Myeloma Working Group recommendations for global myeloma care. Leukemia. 2014;28:981–92.CrossRefPubMed
24.
Zurück zum Zitat Ludwig H, Rauch E, Kuehr T, et al. Lenalidomide and dexamethasone for acute light chain-induced renal failure: A phase II study. Haematologica. 2015;100(3):385–391.CrossRefPubMedPubMedCentral Ludwig H, Rauch E, Kuehr T, et al. Lenalidomide and dexamethasone for acute light chain-induced renal failure: A phase II study. Haematologica. 2015;100(3):385–391.CrossRefPubMedPubMedCentral
25.
Zurück zum Zitat San Miguel JF. Bortezomib just for induction or also for maintenance in myeloma patients with renal impairment? Haematologica. 2014;99(1):140–47.CrossRef San Miguel JF. Bortezomib just for induction or also for maintenance in myeloma patients with renal impairment? Haematologica. 2014;99(1):140–47.CrossRef
26.
Zurück zum Zitat Montseny JJ, Kleinknecht D, Meyrier A, et al. Long-term outcome according to renal histological lesions in 118 patients with monoclonal gammopathies. Nephrol Dial Transplant. 1998;13:1438–45.CrossRefPubMed Montseny JJ, Kleinknecht D, Meyrier A, et al. Long-term outcome according to renal histological lesions in 118 patients with monoclonal gammopathies. Nephrol Dial Transplant. 1998;13:1438–45.CrossRefPubMed
27.
Zurück zum Zitat Palumbo A, Chanan-Khan A, Weisel K, et al. Daratumumab, Bortezomib, and Dexamethasone for multiple myeloma. N Engl J Med. 2016;375:754–66.CrossRefPubMed Palumbo A, Chanan-Khan A, Weisel K, et al. Daratumumab, Bortezomib, and Dexamethasone for multiple myeloma. N Engl J Med. 2016;375:754–66.CrossRefPubMed
28.
Zurück zum Zitat Rajkumar SV. Multiple myeloma: 2014 Update on diagnosis, risk-stratification, and management. Am J Hematol. 2014;89:999–1009.CrossRef Rajkumar SV. Multiple myeloma: 2014 Update on diagnosis, risk-stratification, and management. Am J Hematol. 2014;89:999–1009.CrossRef
29.
Zurück zum Zitat Sonneveld P, et al. Bortezomib induction and maintenance treatment in patients with newly diagnosed multiple myeloma: results of the randomized phase III HOVON-65/GMMG-HD4 trial. J Clin Oncol. 2012;30:2946–55.CrossRefPubMed Sonneveld P, et al. Bortezomib induction and maintenance treatment in patients with newly diagnosed multiple myeloma: results of the randomized phase III HOVON-65/GMMG-HD4 trial. J Clin Oncol. 2012;30:2946–55.CrossRefPubMed
Metadaten
Titel
Renal insufficiency in patients with multiple myeloma
verfasst von
Dr. Boris Bozic
Dr. Sophie Hölbling
Dr. Vanessa Völkel
Prim. Prof. Dr. Christian Sebesta
Publikationsdatum
21.08.2017
Verlag
Springer Vienna
Erschienen in
memo - Magazine of European Medical Oncology / Ausgabe 3/2017
Print ISSN: 1865-5041
Elektronische ISSN: 1865-5076
DOI
https://doi.org/10.1007/s12254-017-0343-3

Weitere Artikel der Ausgabe 3/2017

memo - Magazine of European Medical Oncology 3/2017 Zur Ausgabe