Abstract: SA-PO021

Carfilzomib Treatment and AKI in Patients with Multiple Myeloma

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Authors

  • Camargo, Marianne, Mount Sinai Hospital, New York, New York, United States
  • Chauhan, Kinsuk, Icahn School of Medicine at Mount Sinai, New York, New York, United States
  • Coca, Steven G., Icahn School of Medicine at Mount Sinai, New York, New York, United States
Background

Carfilzomib is a selective proteasome inhibitor approved for the treatment of relapsed and refractory multiple myeloma in patients who have been previously treated with at least two other agents. Initial clinical studies reported renal injury in 25-33% of patients treated, yet clinical trials reported the incidence of acute kidney injury (AKI) between 4-8% when compared to other anti-myeloma agents. Our objective was to evaluate the real-world incidence and severity of AKI that is presumed due to carfilzomib treatment.

Methods

Electronic medical record (EMR) data was extracted from patients who received carfilzomib between 1/2012 and 12/2016 at a major academic medical center. Data included baseline demographics, medical history, and laboratory results including baseline creatinine and follow-up values during the course of treatment. AKI was defined as rise in creatinine by 0.3mg/dl or by 1.5 times increase from baseline. To estimate the incidence of AKI, a Poisson regression was used, adjusting for age, gender, kappa-lambda ratio, adjusted serum calcium, and history of hypertension, heart failure, and chronic kidney disease.

Results

Out of 429 patients identified between 1/2012-12/2017, 86 patients had received more than one dose of carfilzomib and had complete data. The average age was 65 years old, 42% women, 51% White. Forty-one percent of patients had at least one event of AKI. AKI was more common in women (IRR 2.2, 95% CI 1.7-2.8, p<0.01), older age (IRR 1.02 for each year of age, 95% CI 1.01-1.03 p<0.01), and African Americans (IRR 4.75, 95% CI 3.05-7.39, p<0.01).

Conclusion

Carfilzomib is a third line therapeutic agent for patients with refractory/relapsed multiple myeloma. Our analysis showed higher incidence of AKI events when compared to previous trials. Further studies are needed to clarify the epidemiology and risk factors for AKI in this population.