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Kidney Week

Abstract: SA-PO186

Effect of Bortezomib and Male Sex on the Risk for Developing Tumor Lysis Syndrome in Patients with Multiple Myeloma: A Retrospective Study

Session Information

  • Onco-Nephrology: Clinical
    November 09, 2019 | Location: Exhibit Hall, Walter E. Washington Convention Center
    Abstract Time: 10:00 AM - 12:00 PM

Category: Onco-Nephrology

  • 1500 Onco-Nephrology

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
  • 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 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, may increase TLS risk. This investigation was performed to obtain accurate information regarding TLS risk in MM patients.

Methods

We retrospectively investigated the incidences of laboratory and clinical TLS (LTLS and CTLS) in patients who received primary therapy for untreated symptomatic MM between May 2007 and December 2017. To identify potential TLS risk factors, we used univariate and multivariate logistic regression analyses to evaluate the associations between LTLS and several parameters hypothesized to be associated with an increased risk in prior reports.

Results

In total, 210 patients were included in this study. There were 17 (8.1%) and 7 (3.3%) patients with LTLS and CTLS, respectively; all CTLS patients were diagnosed due to elevated serum creatinine. Baseline characteristics were similar between patients with or without LTLS, although patients with LTLS tended to exhibit lower renal function. Multivariate analyses revealed that bortezomib-containing therapy (Bor-CT) was most strongly associated with LTLS (odds ratio (OR)=3.25, P=0.078) and male sex (OR=2.51, P=0.105). In subgroup analysis of patients treated with Bor-CT, male sex was significantly associated with increased risk of LTLS (OR=4.71, P=0.004, vs. other patients who received primary therapy) [Table].

Conclusion

Bor-CT may increase TLS risk, particularly among male patients with MM. Thus, TLS risk should be evaluated based on multifactorial.