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Kidney Week

Abstract: FR-PO229

Treatment of Multiple Myeloma Related Kidney Disease by Bortezomib

Session Information

Category: CKD (Non-Dialysis)

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

Author

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

Only few evaluate the efficacy and safety of bortezomib in the treatment of multiple myeloma(MM) related kidney disease.

Methods

It is a retrospective cohort study. All the eligible patients were enrolled from Department of Nephropathy,Shanghai Ruijin Hospital between Sep 2009 and Aug 2017.Patients diagnosed MM with renal insufficiency were enrolled while patients with relapsed MM were excluded.All the subjects were given a bortezomib based treatment,including PD(bortezomib,dexamethasone)/PAD(bortezomib,adriamycin, dexamethasone)/PCD(bortezomib,cyclophosphamide,dexamethasone).The primary outcome was clinical remission. Definition of hematological remission and renal response were according to the criterion made by IMWG(International Myeloma Working Group).

Results

Totally,53 patients with MM related kidney diseases were recruited in this study.Of the 53 cases,34M & 19F,mean age 59(35-86)y/o,median urinary protein 4.2g/24h,serum albumin 30g/L,EPI-eGFR 19ml/min,10 cases received dialysis therapy.The MM type included 11 IgA,5 IgD,16 IgG,21 Light chain.Of 28 cases with renal biopsy,6(21%)amyloidosis,14(50%) cast nephropathy,6(21%) tubulointerstitial lesions,2(8%) light chain deposition disease(LCDD).The medium follow-up time was 7(3-47)months.Of 32 cases that taken at least 4 cycles of bortezomib treatment, hematological remission showed that 14(44%) achieved CR,9(28%)achieved PR,7(22%)were stable,2(6%) were relapsed;23/32 baseline eGFR<60ml/min,renal response showed that 5(22%) achieved CR,1(4%)achieved PR,12(52%)achieved MR,5(22%)were stable.Of 10 cases that dialysis dependent,5 got rid of dialysis.After treatment,patients showed improvement in clinical features.(Fig 1&2)

Conclusion

Bortezomib can significantly reduce urinary protein, increase EPI-eGFR and improve prognosis of MM related kidney disease,which means making patients benefit.