Abstract: SA-PO0195
Extracorporeal Removal of Free Light Chain in Patients with Nondialysis-Dependent Acute Myeloma
Session Information
- Onconephrology: MGRS, HSCT, Electrolytes, RCC, and More
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1700 Onconephrology
Authors
- Zappulo, Fulvia, Nephrology, Dialysis and Kidney Transplant Unit, IRCCS AOU di Bologna, Bologna, Italy
- Ullo, Ines, Nephrology, Dialysis and Kidney Transplant Unit, IRCCS AOU di Bologna, Bologna, Italy
- Possente, Giuseppe G, Department of Medical and Surgical Sciences DIMEC), Alma Mater Studiorum - University of Bologna, Bologna, Italy
- Scrivo, Anna, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico di Sant'Orsola, Bologna, Emilia-Romagna, Italy
- Carnevali, Virginia, Department of Medical and Surgical Sciences DIMEC), Alma Mater Studiorum - University of Bologna, Bologna, Italy
- Vetrano, Daniele, Department of Medical and Surgical Sciences DIMEC), Alma Mater Studiorum - University of Bologna, Bologna, Italy
- Vischini, Gisella, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico di Sant'Orsola, Bologna, Emilia-Romagna, Italy
- Croci Chiocchini, Anna Laura, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico di Sant'Orsola, Bologna, Emilia-Romagna, Italy
- Tondolo, Francesco, IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico di Sant'Orsola, Bologna, Emilia-Romagna, Italy
- Zamagni, Elena, L&A Seragnoli, IRCCS AOU di Bologna, Bologna, Italy
- La Manna, Gaetano, Nephrology, Dialysis and Kidney Transplant Unit, IRCCS AOU di Bologna, Bologna, Italy
Background
Renal impairment is common in Multiple Myeloma (MM) and represents a leading cause of morbidity and mortality. Extracorporeal removal of FLC has been explored in dialysis-dependent patients, but its role in non-dialysis-dependent AKI remains unclear.
Methods
We conducted a retrospective, monocentric observational study: patients with MM and non-dialysis dependent AKI were enrolled. The aim of the study was to assess the efficacy of extracorporeal FLC removal combined with chemotherapy in the recovery of renal function, defined as the change in eGFR (ΔeGFR) at 12 months.
Results
50 patients were included and divided into 2 groups: Group A (n=24) received extracorporeal FLC removal and chemotherapy, Group B (n=16) received chemotherapy according to the treatment protocol. Group A showed severe kidney involvment at baseline, with lower eGFR (18.1 vs 45.36 ml/min) and higher FLC levels. Due to baseline heterogeneity, propensity score matching (PSM) was applied using age, eGFR, and renal histology as covariates, resulting in 12 matched patients per group. After PSM, Group ml/min/1.73m, p=0.0014) (fig1 ), suggesting a potential role for extracorporeal FLC removal in promoting renal recovery in early-stage AKI.
Conclusion
These findings align with prior studies showing that rapid FLC reduction correlates with better renal outcomes. Large randomized trials which did not demonstrate benefit in non-dialysis-dependent patients. Our study is among the first to show a significant benefit of extracorporeal therapy in a less severe AKI setting, potentially identifying a more responsive patient population. Limitations include the small sample size, retrospective design, and heterogeneity in treatment protocols but further research are required to assess this treatment in mild degree of AKI.