• The lancet oncology · Jul 2023

    Review

    Management of multiple myeloma-related renal impairment: recommendations from the International Myeloma Working Group.

    • Meletios A Dimopoulos, Giampaolo Merlini, Frank Bridoux, Nelson Leung, Joseph Mikhael, Simon J Harrison, Efstathios Kastritis, Laurent Garderet, Alessandro Gozzetti, van de DonkNiels W C JNWCJDepartment of Hematology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands., Katja C Weisel, Ashraf Z Badros, Meral Beksac, Jens Hillengass, Mohamad Mohty, P Joy Ho, Ioannis Ntanasis-Stathopoulos, Maria-Victoria Mateos, Paul Richardson, Joan Blade, Philippe Moreau, Jesus San-Miguel, Nikhil Munshi, S Vincent Rajkumar, DurieBrian G MBGMDepartment of Hematology/Oncology, Cedars-Sinai Medical Center, Los Angeles, CA, USA., Heinz Ludwig, Evangelos Terpos, and International Myeloma Working Group.
    • Department of Clinical Therapeutics, School of Medicine, National and Kapodistrian University of Athens, Alexandra General Hospital, Athens, Greece.
    • Lancet Oncol. 2023 Jul 1; 24 (7): e293e311e293-e311.

    AbstractHere, the International Myeloma Working Group (IMWG) updates its clinical practice recommendations for the management of multiple myeloma-related renal impairment on the basis of data published until Dec 31, 2022. All patients with multiple myeloma and renal impairment should have serum creatinine, estimated glomerular filtration rate, and free light chains (FLCs) measurements together with 24-h urine total protein, electrophoresis, and immunofixation. If non-selective proteinuria (mainly albuminuria) or involved serum FLCs value less than 500 mg/L is detected, then a renal biopsy is needed. The IMWG criteria for the definition of renal response should be used. Supportive care and high-dose dexamethasone are required for all patients with myeloma-induced renal impairment. Mechanical approaches do not increase overall survival. Bortezomib-based regimens are the cornerstone of the management of patients with multiple myeloma and renal impairment at diagnosis. New quadruplet and triplet combinations, including proteasome inhibitors, immunomodulatory drugs, and anti-CD38 monoclonal antibodies, improve renal and survival outcomes in both newly diagnosed patients and those with relapsed or refractory disease. Conjugated antibodies, chimeric antigen receptor T-cells, and T-cell engagers are well tolerated and effective in patients with moderate renal impairment.Copyright © 2023 Elsevier Ltd. All rights reserved.

      Pubmed     Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…