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Kidney Week

Abstract: FR-PO228

Bortezomib in the Treatment of Kidney Light Chain Amyloidosis

Session Information

Category: CKD (Non-Dialysis)

  • 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Author

  • Chen, Nan, Ruijin Hospital, Shanghai, China
Background

Light-chain amyloidosis is a clonal plasma cell disorder. It can cause kidney injury including proteinuria and abnormal renal function . This study is in order to evaluate the efficacy of Bortezomib in the treatment of Kidney Light Chain Amyloidosis,

Methods

This is a retrospective study. All participants were recruited from Department of Nephropathy, Shanghai Ruijin Hospital between February 2013 to February 2018. The diagnosis of Kidney light chain amyloidosis(KAL) was based on kidney biopsy. All the patients were given BD therapy per month (Bortezomib 1.3mg/m2 BSA on day 1,4,8,11, Dex on day 1-4 and 8-11). The primary outcome was kidney complete response(CR) defined as at least 50% reduction in 24-hour urinary protein(24hUP) compared to baseline, plus the decrease of estimated GFR(calculated by EPI-Creatinine equation) was less than 25% compared to baseline. Partial response(PR) was defined as 24hUP reduction within 20%~50%. Non response was defined as 24hUP reduction less than 20% or the decrease of eGFR more than or equal to 25%.

Results

Thirty patients were diagnosed as KAL in this study. Of all the patients, 18 (60%) were male and mean age was 56 (35-69) years old. Totally, 24 (80%) patients were λ type KAL, 6 (20%) patients were κ type KAL. Nineteen patients (63.3%) were CKD stage 1, 8 patients (26.7%) were CKD stage 2 and 3 patients (10%) were CKD stage 3~5. The mean frequency of BD therapy was 3.8 (1-12) times and the mean follow-up period was 8.21 (3-28) months after advanced remission or treatment. Finally, 12 of 30 patients (40%) reached CR,4 reached PR (13%). After BD therapy , the 24hUP was significantly decreased compared to baseline (3.6 vs 5.2 g/24h, P<0.05), serum albumin was increased (23.9 vs 28.13g/L, P<0.005)and there was no decrease of eGFR(83.9 vs 87.9, p=0.228).(Figure 1)

Conclusion

Bortezomib was effective in the treatment of patients with KAL and the renal remission rate of our study was 53%.

Bortezomib in the Treatment of Kidney Light Chain Amyloidosis