Light chain muscle deposition caused rhabdomyolysis and acute renal failure in patient with multiple myeloma

2005 ◽  
Vol 63 (01) ◽  
pp. 50-53 ◽  
Author(s):  
R. Farah ◽  
R. Farah ◽  
M. Kolin ◽  
H. Cohen ◽  
B. Kristal
Keyword(s):  
Multiple Myeloma ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Light Chain

Light Chain–Induced Acute Renal Failure Can Be Reversed by Bortezomib-Doxorubicin-Dexamethasone in Multiple Myeloma: Results of a Phase II Study

2010 ◽  
Vol 28 (30) ◽  
pp. 4635-4641 ◽  
Author(s):  
Heinz Ludwig ◽  
Zdenek Adam ◽  
Roman Hajek ◽  
Richard Greil ◽  
Elena Tóthová ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Partial Response ◽  
Light Chain ◽  
Tumor Response ◽  
Minor Response ◽  
Renal Response ◽  
Previously Treated Patients ◽  
Previously Treated

Purpose To assess the efficacy of bortezomib-doxorubicin-dexamethasone (BDD) therapy in patients with multiple myeloma with light chain–induced acute renal failure. Patients and Methods Sixty-eight patients with light chain–induced acute renal failure and glomerular filtration rate (GFR) less than 50 mL/min received bortezomib (1.0 mg/m2 on days 1, 4, 8, and 11), doxorubicin (9 mg/m2 on days 1 and 4), and dexamethasone (40 mg on days 1, 4, 8, and 11); if well tolerated after two cycles, bortezomib could be increased to 1.3 mg/m2 and doxorubicin administered on days 1, 4, 8, and 11. Results By intent-to-treat analysis a myeloma response was obtained in 72% of 18 previously and 50 not previously treated patients (complete response [CR]/near CR [nCR], 38%; very good partial response [VGPR], 15%; partial response [PR], 13%; minor response [MR], 6%). Renal response was achieved in 62% of patients (renal CR, 31%; renal PR, 7%; renal MR, 24%). Median GFR increased from 20.5 to 48.4 mL/min. GFR improvement correlated with tumor response; the greatest increase to 59.6 mL/min was seen in the group of patients with CR/nCR/VGPR. Median progression-free survival was 12.1 months. One- and 2-year survival rates were 72% and 58%, respectively. Survival did not differ between patients with and without renal response but was inferior in previously treated patients (P < .001). In multivariate analysis, baseline GFR and tumor response correlated with renal response, and pretreatment status, lactate dehydrogenase, and myeloma response correlated with survival. The most common grade 3 or 4 toxicities were infection (19.1%), thrombocytopenia (14.7%), neutropenia (14.7%), fatigue/weakness (10.3%), and polyneuropathy (8.8%). Conclusion BDD induced a high rate of myeloma and renal responses, and treatment was well tolerated.

Chemotherapy with or without plasmapheresis in acute renal failure due to multiple myeloma: a meta-analysis

2015 ◽  
Vol 53 (05) ◽  
pp. 391-397 ◽  
Author(s):  
Xiaoyong Yu ◽  
Liangying Gan ◽  
Zhaohui Wang ◽  
Bao Dong ◽  
Xiaohong Chen
Keyword(s):  
Multiple Myeloma ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Meta Analysis

scholarly journals FP45483 PERCENT OF RENAL RECOVERY IN 24 TREATMENTS OF ACUTE RENAL FAILURE SECONDARY TO MULTIPLE MYELOMA WITH HIGH CUT-OFF FILTERS

2018 ◽  
Vol 33 (suppl_1) ◽  
pp. i188-i188
Author(s):  
Rafael Alvarez Lipe ◽  
Ana Berni Wennekers ◽  
Patricia Vernet Perna ◽  
Vanessa Guerrero Granados ◽  
Hilda Villafuerte Ledesma ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Renal Recovery

Acute Renal Failure in Patients With Multiple Myeloma

1984 ◽  
Vol 132 (2) ◽  
pp. 416-416
Author(s):  
D.J. Cohen ◽  
W.H. Sherman ◽  
E.F. Osserman ◽  
G.B. Appel
Keyword(s):  
Multiple Myeloma ◽  
Renal Failure ◽  
Acute Renal Failure

Acute Renal Failure in Multiple Myeloma

1971 ◽  
Vol 105 (1) ◽  
pp. 21-23 ◽  
Author(s):  
Carl R. Kjeldsberg ◽  
Richard E. Holman
Keyword(s):  
Multiple Myeloma ◽  
Renal Failure ◽  
Acute Renal Failure

Improving Outcomes in Patients with Renal Failure Secondary to Multiple Myeloma: Results From ChAR2M2.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 1875-1875
Author(s):  
Colin Hutchison ◽  
Parisa Airia ◽  
Mark Cook ◽  
Daniel Grima
Keyword(s):  
Multiple Myeloma ◽  
Renal Failure ◽  
Side Effects ◽  
Light Chain ◽  
De Novo ◽  
Conflicts Of Interest ◽  
Treatment Patterns ◽  
Free Light Chain ◽  
High Rate ◽  
Sustained Reduction

Abstract Abstract 1875 Poster Board I-900 Study purpose: To explore how free light chain (FLC) removal by high cut-off haemodialysis (HCO-HD) has been adopted into clinical practice for the management of renal failure secondary to multiple myeloma. Describing treatment patterns and the laboratory and clinical outcomes associated with its use. Methods: A chart audit of patients treated with FLC removal by HCO-HD, using the Gambro HCO 1100 dialyser, was performed in 16 dialysis centers across 9 countries. Patient demographics, treatment patterns and dialysis side-effects were recorded. In addition, the following outcomes were measured: dialysis independence and reductions in serum FLCs concentrations at 12 and 21 days. Results: Data for 66 patients was entered. Patients had an average age of 65.1 (SD×10.1); 42 of them (63.64%) were male and 24 (36.36%) were female. Sixteen (24%) presented with relapsing myeloma and 50 (76%) had de novo disease. On average, each patient received 13 HCO-HD sessions (SD×8). Forty-one patients became dialysis independent (62.12%), after an average of 12 sessions. Dialysis related side-effects were reported in 6% of all patients. Forty patients (60.61%) were reported to have a sustained reduction in serum FLC concentrations by day 12. By day 21 this had increased to forty-one (62.12%). Among the patients who achieved a sustained reduction in serum FLC concentrations, 28 (70%) had a decline in FLC levels of more than 50% by day 12 and 34 (82.93%) by day 21. Among patients who achieved sustained reduction of more than 50% in serum FLC concentrations by day 12, 75% became dialysis independent. In comparison only 53% of those with a reduction of less than 50% became dialysis independent (p×0.007). Furthermore, among patients who achieved sustained FLC reduction of greater than 75%, 81% became dialysis independent. The rate of dialysis independence was also significantly higher in patients with de novo disease compared with those with relapsing myeloma (64% versus 56%, p×0.04). Conclusion: Free light chain removal by HCO-HD was well tolerated and associated with a very high rate of dialysis independence in patients with renal failure secondary to multiple myeloma. Rates of renal recovery were greater in patients with de novo myeloma and those who achieved an early reduction in serum FLC concentrations. Disclosures: No relevant conflicts of interest to declare.

Combined Bendamustine, Prednisone and Bortezomib (BPV) In Patients With Relapsed Or Refractory Multiple Myeloma and Light Chain Induced Renal Failure

Blood ◽  
2013 ◽  
Vol 122 (21) ◽  
pp. 3203-3203 ◽  
Author(s):  
Wolfram Pönisch ◽  
Barbara Moll ◽  
Dietger Niederwieser
Keyword(s):  
Multiple Myeloma ◽  
Renal Failure ◽  
Renal Dysfunction ◽  
Light Chain ◽  
Severe Side Effect ◽  
Renal Response ◽  
Group A ◽  
Severe Renal Dysfunction ◽  
Grade 3 ◽  
Group B

Abstract Introduction Serious renal failure represents a main complication of Multiple Myeloma (MM). An estimated 25% to 50% of patients are affected during the course of their disease. These patients are at increased risk for infections and have a significantly worse prognosis. Small phase I/II studies suggest that treatment with chemotherapy and/or new substances results in recovery of renal function in more than 25%. The window of opportunity for reversal of renal impairment is rather small making an immediate and highly active treatment strategy mandatory. Bortezomib and bendamustine have turned out to be quickly acting and effective drugs in the treatment of MM. Methods Between March 2005 and March 2013, 36 patients (median age 64; range 32-81 years) with relapsed/refractory MM and light chain induced renal failure (creatinine clearance <60ml/min) were treated with bendamustine 60mg/qm on day 1 and 2, bortezomib 1.3mg/qm on day 1, 4, 8 and 11, and prednisone 100mg on day 1, 2, 4, 8 and 11. Cycles were repeated every 21 days. Patients were divided into two groups: group A (n=20) consisted of patients with moderate or severe renal dysfunction (eGFR 15-59ml/min) and group B (n=16) of patients with renal failure/dialysis (eGFR <15ml/min). Results The median number of the BPV-treatment was 2 (1-7) cycles. 24 patients (67%) responded after at least one cycle of chemotherapy with 3 CR, 3 nCR, 6 VGPR, and 12 PR. Six patients had MR, 2 patients stable disease and 4 patients had a progress. With a median follow up of 22 months of the surviving patients, median PFS and OS for patients with moderate or severe renal dysfunction (group A) were 10 months and 25 months, respectively. Outcome for these patients was significantly better compared to patients with renal failure/dialysis (group B) with a median PFS and OS of 3 months and 7 months, respectively (p<0.02). Eleven patients showed a CRrenal, 5 patients a PRrenal and 15 patients a MRrenal. Median time to first renal response and best renal response were 21 days and 42 days, respectively. The most common severe side effect was grade 3-4 thrombocytopenia in 81% of the patients. Grade 3-4 neutropenia was observed in 50% of the patients. Moderate to severe infections were seen in 13 patients. Summary These results indicate that the combination of bortezomib, bendamustine and prednisone is effective and well tolerated in patients with relapsed/refractory MM and light chain induced renal failure. Disclosures: No relevant conflicts of interest to declare.

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