Renal outcome in multiple myeloma patients with cast nephropathy: a retrospective analysis of potential predictive values on clinical and renal outcome
Objective Cast nephropathy (CN) is the leading cause of acute kidney injury (AKI) in multiple myeloma (MM). Since it is sparsely documented why some patients with CN do achieve a renal response while others do not, we describe a single-center cohort of patients with multiple myeloma and biopsy-confi...
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| Language: | English |
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Taylor & Francis Group
2024-12-01
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| Series: | Hematology |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/16078454.2024.2311600 |
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| author | Lina Z. Rüsing Nicolas Kozakowski Georg Jeryczynski Lea Vospernik Julia Riedl Thomas Reiter Heinz Gisslinger Hermine Agis Maria-Theresa Krauth |
| author_facet | Lina Z. Rüsing Nicolas Kozakowski Georg Jeryczynski Lea Vospernik Julia Riedl Thomas Reiter Heinz Gisslinger Hermine Agis Maria-Theresa Krauth |
| author_sort | Lina Z. Rüsing |
| collection | DOAJ |
| description | Objective Cast nephropathy (CN) is the leading cause of acute kidney injury (AKI) in multiple myeloma (MM). Since it is sparsely documented why some patients with CN do achieve a renal response while others do not, we describe a single-center cohort of patients with multiple myeloma and biopsy-confirmed CN to evaluate potential markers of renal response.Methods The data was collected as a retrospective, single-center analysis of CN-patients treated at the Medical University Vienna between 01/01/2004 and 01/01/2022. Baseline parameters and clinical outcome was compared between renal responders and non-responders.Results Among 28 patients with CN, n = 23 were assessed for renal response (14 responders; 9 non-responders). Renal responders were younger (median age: 61 years; 77 years, p = 0.039), showed higher overall survival (153months; 58months, p = 0.044) and achieved hematologic response (≥PR) to first-line therapy (p = 0.029), and complete hematologic response (CR) at any time (p = 0.025) significantly more often. Further, we could show that rapid initiation of anti-myeloma therapy after initial presentation correlated significantly with renal response (median 9 days; 27 days, p = 0.016). Analyses of kidney biopsy specimens revealed that patients with a high IF/TA score showed end stage renal disease (dialysis ≥ 3 months) significantly more often (p = <0.001).Discussion In summary, our data suggests, that a rapid start with systemic hematologic treatment in patients with MM and CN is crucial and achieving an early hematologic response is important for renal recovery. Moreover, achieving a deep hematologic response and subsequent renal recovery improves clinical outcome as reflected by an overall survival benefit. |
| format | Article |
| id | doaj-art-7c9dfcfc25e640378353bbb120d02a5d |
| institution | DOAJ |
| issn | 1607-8454 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Hematology |
| spelling | doaj-art-7c9dfcfc25e640378353bbb120d02a5d2025-08-20T02:50:19ZengTaylor & Francis GroupHematology1607-84542024-12-0129110.1080/16078454.2024.2311600Renal outcome in multiple myeloma patients with cast nephropathy: a retrospective analysis of potential predictive values on clinical and renal outcomeLina Z. Rüsing0Nicolas Kozakowski1Georg Jeryczynski2Lea Vospernik3Julia Riedl4Thomas Reiter5Heinz Gisslinger6Hermine Agis7Maria-Theresa Krauth8Department of Medicine I, Division Hematology and Hemostaseology, Medical University Vienna, AustriaDepartment of Pathology, Medical University of ViennaDepartment of Medicine I, Division Oncology, Medical University ViennaDepartment of Medicine I Division Hematology and Hemostaseology, Medical University ViennaDepartment of Medicine I, Division Hematology and Hemostaseology, Medical University Vienna, AustriaDepartment of Medicine III, Division of Nephrology and Dialysis, Medical University of ViennaDepartment of Medicine I, Division Hematology and Hemostaseology, Medical University Vienna, AustriaDepartment of Medicine I, Division Hematology and Hemostaseology, Medical University Vienna, AustriaDepartment of Medicine I, Division Hematology and Hemostaseology, Medical University Vienna, AustriaObjective Cast nephropathy (CN) is the leading cause of acute kidney injury (AKI) in multiple myeloma (MM). Since it is sparsely documented why some patients with CN do achieve a renal response while others do not, we describe a single-center cohort of patients with multiple myeloma and biopsy-confirmed CN to evaluate potential markers of renal response.Methods The data was collected as a retrospective, single-center analysis of CN-patients treated at the Medical University Vienna between 01/01/2004 and 01/01/2022. Baseline parameters and clinical outcome was compared between renal responders and non-responders.Results Among 28 patients with CN, n = 23 were assessed for renal response (14 responders; 9 non-responders). Renal responders were younger (median age: 61 years; 77 years, p = 0.039), showed higher overall survival (153months; 58months, p = 0.044) and achieved hematologic response (≥PR) to first-line therapy (p = 0.029), and complete hematologic response (CR) at any time (p = 0.025) significantly more often. Further, we could show that rapid initiation of anti-myeloma therapy after initial presentation correlated significantly with renal response (median 9 days; 27 days, p = 0.016). Analyses of kidney biopsy specimens revealed that patients with a high IF/TA score showed end stage renal disease (dialysis ≥ 3 months) significantly more often (p = <0.001).Discussion In summary, our data suggests, that a rapid start with systemic hematologic treatment in patients with MM and CN is crucial and achieving an early hematologic response is important for renal recovery. Moreover, achieving a deep hematologic response and subsequent renal recovery improves clinical outcome as reflected by an overall survival benefit.https://www.tandfonline.com/doi/10.1080/16078454.2024.2311600Multiple myelomacast nephropathyrenal responserenal recoverykidney biopsyacute kidney injury |
| spellingShingle | Lina Z. Rüsing Nicolas Kozakowski Georg Jeryczynski Lea Vospernik Julia Riedl Thomas Reiter Heinz Gisslinger Hermine Agis Maria-Theresa Krauth Renal outcome in multiple myeloma patients with cast nephropathy: a retrospective analysis of potential predictive values on clinical and renal outcome Hematology Multiple myeloma cast nephropathy renal response renal recovery kidney biopsy acute kidney injury |
| title | Renal outcome in multiple myeloma patients with cast nephropathy: a retrospective analysis of potential predictive values on clinical and renal outcome |
| title_full | Renal outcome in multiple myeloma patients with cast nephropathy: a retrospective analysis of potential predictive values on clinical and renal outcome |
| title_fullStr | Renal outcome in multiple myeloma patients with cast nephropathy: a retrospective analysis of potential predictive values on clinical and renal outcome |
| title_full_unstemmed | Renal outcome in multiple myeloma patients with cast nephropathy: a retrospective analysis of potential predictive values on clinical and renal outcome |
| title_short | Renal outcome in multiple myeloma patients with cast nephropathy: a retrospective analysis of potential predictive values on clinical and renal outcome |
| title_sort | renal outcome in multiple myeloma patients with cast nephropathy a retrospective analysis of potential predictive values on clinical and renal outcome |
| topic | Multiple myeloma cast nephropathy renal response renal recovery kidney biopsy acute kidney injury |
| url | https://www.tandfonline.com/doi/10.1080/16078454.2024.2311600 |
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