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Kidney Week

Abstract: TH-PO062

Bortezomib-Induced Tumor Lysis Syndrome in Patients with Untreated Symptomatic Multiple Myeloma: A Retrospective Study

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

  • Kondo, Masahiro, Nagoya City University Hospital, Nagoya, Japan
  • Hotta, Yuji, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
  • Yamauchi, Karen, Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
  • Sanagawa, Akimasa, Nagoya City University Hospital, Nagoya, Japan
  • Komatsu, Hirokazu, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Iida, Shinsuke, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • Kimura, Kazunori, Nagoya City University Hospital, Nagoya, Japan
Background

Tumor lysis syndrome (TLS) causes acute kidney injury (AKI) and is a complication of cancer chemotherapy. TLS risk is classified by malignant disease type. Although multiple myeloma (MM) is a low-risk disease, treatment by novel therapies, including bortezomib (Bor), may increase TLS risk. Thus, we evaluated the association between Bor-based therapy and TLS in MM patients.

Methods

We retrospectively reviewed patients who received first-line therapy for untreated symptomatic MM between May 2007 and December 2017. Patients treated by Bor-based therapy comprised the Bor group; all remaining patients (i.e., those treated by conventional anti-cancer agents) comprised the Non-Bor group. Incidences of laboratory and clinical TLS (LTLS and CTLS) during first-line therapy were compared between groups.

Results

There were 129 and 75 patients in Bor and Non-Bor groups, respectively. Baseline laboratory data were similar between groups. More patients received prophylactic administration for hyperuricemia in Bor group than in Non-Bor group. However, LTLS incidence was significantly higher in Bor group than in Non-Bor group (12.4% vs. 4.0%, P<0.05); CTLS was observed in eight patients (6.2%) in Bor group and one (1.3%) in Non-Bor group [Table]; these patients were diagnosed with CTLS due to elevated serum creatinine. Three CTLS patients with AKI were in Bor group. No CTLS patients died or referred for dialysis during treatment period.

Conclusion

Bor-based therapy may increase risk of AKI in LTLS and CTLS, even with prophylactic interventions. TLS risk must be further evaluated in low-risk diseases such as MM, as an increasing number of novel therapies can achieve tumor shrinkage.