Abstract: FR-PO229
Treatment of Multiple Myeloma Related Kidney Disease by Bortezomib
Session Information
- CKD: Clinical, Outcomes, Trials - II
October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
Abstract Time: 10:00 AM - 12:00 PM
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.