Abstract: SA-PO358

Renal Biopsy Results from Patients with Multiple Myeloma – Data from a Comprehensive National Cancer Institute: A 10 Year MD Anderson Experience

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 301 CKD: Risk Factors for Incidence and Progression

Authors

  • Lakhani, Laila S., UT Houston, Houston, Texas, United States
  • Selamet, Umut, MD Anderson Cancer Center, Houston, Texas, United States
  • Ziaolhagh, Ali, University of Texas, Housotn, Texas, United States
  • Glass, William F., University of Texas – Houston Medical School, Houston, Texas, United States
  • Tchakarov, Amanda, University of Texas Medical School at Houston, Houston, Texas, United States
  • Abudayyeh, Ala, The University of Texas MD Anderson Cancer Center, Houston, Texas, United States
Background

Around 50% of patients with Multiple Myeloma (MM) have renal involvement at presentation. Renal lesions in MM is both heterogeneous and multifactorial. We set out to study the spectrum of these deposits and electron micrographic lesions, to determine their extent and correlation with biochemical paraproteinemia, clinically significant proteinuria and the other systemic findings in this population.

Methods

Data is extracted from the retrospective chart review of all patients at MD Anderson Cancer Center who received a renal biopsy between Jan 2008 – June 2017

Results

Out of 193 patients who underwent renal biopsy during this period, 39 had the diagnosis of Multiple Myeloma at the time of biopsy, with 14/39 (36%) on active chemotherapy and 11/39 s/p stem cell transplant. An equal gender distribution was noted (19 females, 20 males) with an average age of 62.5 years. The co-existing medical conditions included HTN (69%), DM (31%), and rarely other malignancies (8%).The most common indication for renal biopsy was AKI -85%, followed by proteinuria in 67% patients - (28% had nephrotic range proteinuria). 2/39 were inadequate biopsy samples. From the remaining 37 biopsies, 13/37 (35%) had glomerulopathy and tubulopathy from cast deposition, 4/37 (11%) had AL Amyloidosis and 1 patient had granulomatous TIN (AFB/fungal stains negative). Interestingly 19/37 (51%) had no evidence of ‘myeloma kidney’; the most common findings in these patients were focal global glomerulosclerosis, hypertensive arterial and arteriolar glomerulosclerosis and diabetic nodular glomerulosclerosis.

Conclusion

The severity of renal involvement confers worse prognosis in patients with Multiple Myeloma. The biopsy findings helps us to predict outcomes and tailor our clinical approach and treatment regimens to minimize morbidity and mortality in patients with Multiple Myeloma.

Funding

  • Clinical Revenue Support