Current approaches to treating of patients with multiple myeloma with renal failure: Questions and proofs


Cite item

Full Text

Abstract

Renal failure (RF) is detected in 20-30% of patients at the onset of multiple myeloma (MM), in 50% of patients during its progression. The advent of new, highly effective agents has considerably expanded the possibilities of treatment in MM patients. Unfortunately, patients with RF, especially those with severe RF, were not included in the majority of investigations. The available data are based on the results of treatment in small groups of patients generally without the morphological identification of nephropathies, with varying severity of RF, which explains significant differences in renal response rates. This review analyzes the results of the most important studies and gives recommendations for treatment in accordance with national and international standards.

About the authors

I G Rekhtina

ФГБУ «Гематологический научный центр» Минздрава России

Москва, Россия

L P Mendeleeva

ФГБУ «Гематологический научный центр» Минздрава России

Москва, Россия

References

  1. Соловьев М.В., Менделеева Л.П., Покровская О.С., Грибанова Е.О., Накастоев И.М.. Гемджян Э.Г., Володичева Е.М., Анчукова Л.В.. Фролова М.В., Меньшакова С.Н.. Осюнихина С.М., Машнина Н.Н., Войцеховский В.В., Филатова Е.А., Беляева С.С., Борисенкова Е.А., Верхогляд И.С., Мостовая В.З., Воронова Е.В., Лапин В.А., Гвоздарева А.С., Гриценко Т.А., Давыдова Ж.А., Калиновская Е.Ю., Цинченко Я.Д., Кириллова Е.Г., Капланов К.Д., Капорская Т.С., Киселева М.Я., Константинова Т.С., Ксензова Т.И., Шакиров И.И., Мартынова Е.В., Михалев М.А., Патраковва Е.В., Попова Н.Б., Поспелова Т.И., Рачкова Н.Н., Савинова М.Т., Самойлова О.С., Морозов Д.Н., Алексеева А.Н., Сычева Т.М., Тарасенкова Е.В., Савченко В.Г. Эпидемиология множественной миеломы в России (результаты многоцентрового межрегионального исследования). Гематология и трансфузиология. 2016;61(1,прил.1):28.
  2. Менделеева Л.П., Вотякова О.М., Покровская О.С., Рехтина И.Г., Дарская Е.И., Гальцева И.В., Капланов К.Д., Моторин Д.В., Самойлова О.С., Семочкин С.В., Скворцова Н.В., Соловьев М.В., Урнова Е.С., Савченко В.Г. Национальные клинические рекомендации по диагностике и лечению множественной миеломы. Гематология и трансфузиология. 2016; 61 (1,прил.2):2-24. https://doi.org/10.18821/0234-5730-2016-61-1
  3. Dimopoulos M, Sonneveld P, Leung N, Merlini G, Ludwig H, Kastritis E, Goldschmidt H, Joshua D, Orlowski R, Powles R, Vesole D, Garderet L, Einsele H, Palumbo A, Cavo M, Richardson P, Moreau P, San Miguel J, Rajkumar S, Durie B, Terpos E. International Myeloma Working Group Recommendations for the Diagnosis and Management of Myeloma-Related Renal Impairment. J Clin Oncol. 2016;34:1544-1557. https://doi.org/10.1200/JCO.2015.65.0044
  4. Knudsen LM, Hjorth M, Hippe E. Renal failure in multiple myeloma: reversibility and impact on the prognosis. Nordic Myeloma Study Group. Eur J Haematol. 2000; 65(3):175-181.
  5. Ludwig H, Rauch E, Kuehr T, Adam Z, Weissmann A, Kasparu H, Autzinger E, Heintel D, Greil R, Poenisch W, Muldur E, Zojer N. Lenalidomide and dexamethasone for acute light chain-induced renal failure: a phase II study. Haematologica. 2014;100:385-391. https://doi.org/10.3324/haematol.2014.115204
  6. Uttervall K, Duru A, Lund J, Liwing J, Gahrton G, Holmberg E, Aschan J, Alici E, Nahi H. The use of novel drugs can effectively improve response, delay relapse and enhance overall survival in multiple myeloma patients with renal impairment. PLoS ONE. 2014;9:e101819. https://doi.org/10.1371/journal.pone.0101819
  7. Gonsalves W, Leung N, Rajkumar S, Dispenzieri A, Lacy M, Hayman S, Buadi F, Dingli D, Kapoor P, Go R, Lin Y, Russell S, Lust J, Zeldenrust S, Kyle R, Gertz M, Kumar S. Improvement in renal function and its impact on survival in patients with newly diagnosed multiple myeloma. Blood Cancer J. 2015;5:e296. https://doi.org/10.1038/bcj.2015.20
  8. Nasr SH, Valeri AM, Sethi S, Fidler ME, Cornell LD, Gertz MA, Lacy M, Dispenzieri A, Rajkumar SV, Kyle RA, Leung N. Clinicopathologic correlations in multiple myeloma: a case series of 190 patients with kidney biopsies. AmJKidneyDis. 2012; 59(6):786-794. https://doi.org/10.1053/j.ajkd.2011.12.028
  9. Рехтина И.Г., Менделеева Л.П., Бирюкова Л.С. Диализзависимая почечная недостаточность у больных множественной миеломой: факторы обратимости. Терапевтический архив. 2015; 7:72-76.
  10. Hutchison C, Heyne N, Airia P, Schindler R, Zickler D, Cook M, Cockwell P, Grima D. Immunoglobulin free light chain levels and recovery from myeloma kidney on treatment with chemotherapy and high cut-off haemodialysis. Nephrol Dial Transplant. 2012;27:3823-3828. https://doi.org/10.1093/ndt/gfr773
  11. Ecotière L, Thierry A, Debiais-Delpech C, Chevret S, Javaugue V, Desport E, Belmouaz S, Quellard N, Kaaki S, Goujon J, Fermand J, Touchard G, Bridoux F. Prognostic value of kidney biopsy in myeloma cast nephropathy: a retrospective study of 70 patients. Nephrol Dial Transplant. 2015;31:64-72. https://doi.org/10.1093/ndt/gfw056
  12. Roussou M, Kastritis E, Migkou M, Psimenou E, Grapsa I, Matsouka C, Barmparousi D, Terpos E, Dimopoulos M. Treatment of patients with multiple myeloma complicated by renal failure with bortezomib-based regimens. Leuk Lymph. 2008;49:890-895. https://doi.org/10.1080/10428190801930506
  13. Morabito F, Gentile M, Ciolli S, Petrucci M, Galimberti S, Mele G, Casulli A, Mannina D, Piro E, Pinotti G, Palmieri S, Catalano L, Callea V, Offidani M, Musto P, Bringhen S, Baldini L, Tosi P, Di Raimondo F, Boccadoro M, Palumbo A, Cavo M. Safety and efficacy of bortezomib-based regimens for multiple myeloma patients with renal impairment: a retrospective study of Italian Myeloma Network GIMEMA. European J Haematol. 2010;84:223-228. https://doi.org/10.1111/j.1600-0609.2009.01385
  14. Ludwig H, Adam Z, Hajek R, Greil R, Tothova E, Keil F, Autzinger E, Thaler J, Gisslinger H, Lang A, Egyed M, Womastek I, Zojer N. Light chain-induced acute renal failure can be reversed by bortezomib-doxorubicin-dexamethasone in multiple myeloma: results of a phase II study. J Clin Oncol. 2010;28:4635-4641. https://doi.org/10.1200/JCO.2010.28.1238
  15. Dimopoulos M, Richardson P, Schlag R, Khuageva N, Shpilberg O, Kastritis E, Kropff M, Petrucci M, Delforge M, Alexeeva J, Schots R, Masszi T, Mateos M, Deraedt W, Liu K, Cakana A, van de Velde H, San Miguel J. VMP (Bortezomib, Melphalan, and Prednisone) Is active and well tolerated in newly diagnosed patients with multiple myeloma with moderately impaired renal function, and results in reversal of renal impairment: cohort analysis of the phase III VISTA Study. J Clin Oncol. 2009;27:6086-6093. https://doi.org/10.1200/JCO.2009.22.2232
  16. Dimopoulos M, Roussou M, Gavriatopoulou M, Psimenou E, Eleutherakis-Papaiakovou E, Migkou M, Matsouka C, Mparmparousi D, Gika D, Kafantari E, Ziogas D, Fotiou D, Panagiotidis I, Terpos E, Kastritis E. Bortezomib-based triplets are associated with a high probability of dialysis independence and rapid renal recovery in newly diagnosed myeloma patients with severe renal failure or those requiring dialysis. Am J Hematol. 2016;91:499-502. https://doi.org/10.1002/ajh.24335
  17. Scheid C, Sonneveld P, Schmidt-Wolf I, van der Holt B, Jarari L, Bertsch U, Salwender H, Zweegman S, Blau I, Vellenga E, Weisel K, Pfreundschuh M, Jie K, Neben K, van de Velde H, Duehrsen U, Schaafsma M, Lindemann W, Kersten M, Peter N, Hanel M, Croockewit S, Martin H, Wittebol S, Bos G, van Marwijk-Kooy M, Wijermans P, Goldschmidt H, Lokhorst H. Bortezomib before and after autologous stem cell transplantation overcomes the negative prognostic impact of renal impairment in newly diagnosed multiple myeloma: a subgroup analysis from the HOVON-65/GMMG-HD4 trial. Haematologica. 2013;99:148-154. https://doi.org/10.3324/haematol.2013.087585
  18. Рехтина И.Г., Менделеева Л.П., Варламова Е.Ю., Бирюкова Л.С. Сравнение эффективности бортезомибсодержащих программ в достижении раннего гематологического и почечного ответа у больных миеломной нефропатией с диализзависимой почечной недосточностью. Гематологияитрансфузиология. 2015;60(4):4-7.
  19. Cohen Y, Joffe E, Benyamini N, Dimopoulos M, Terpos E, Trestman S, Held-Kuznetsov V, Avivi I, Kastritis E. Primary failure of bortezomib in newly diagnosed multiple myeloma — understanding the magnitude, predictors, and significance. Leuk Lymph. 2016;57:1382-1388. https://doi.org/10.3109/10428194.2015.1121258
  20. Dimopoulos M, Roussou M, Gkotzamanidou M, Nikitas N, Psimenou E, Mparmparoussi D, Matsouka C, Spyropoulou-Vlachou M, Terpos E, Kastritis E. The role of novel agents on the reversibility of renal impairment in newly diagnosed symptomatic patients with multiple myeloma. Leuk. 2012;27:423-429. https://doi.org/10.1038/leu.2012.182
  21. Ludwig H, Kasparu H, Müldür E, Zojer N. Lenalidomide and dexamethasone for acute light chain-induced renal failure: a phase II study. Haematologica. 2015;100(3):385-391. https://doi.org/10.3324/haematol.2014.115204
  22. Leung N, Gertz M, Zeldenrust S, Rajkumar S, Dispenzieri A, Fervenza F, Kumar S, Lacy M, Lust J, Greipp P, Witzig T, Hayman S, Russell S, Kyle R, Winters J. Improvement of cast nephropathy with plasma exchange depends on the diagnosis and on reduction of serum free light chains. Kidney Intern. 2008;73:1282-1288. https://doi.org/10.1038/ki.2008.108
  23. Hutchison C, Bradwell A, Cook M, Basnayake K, Basu S, Harding S, Hattersley J, Evans N, Chappel M, Sampson P, Foggensteiner L, Adu D, Cockwell P. Treatment of acute renal failure secondary to multiple myeloma with chemotherapy and extended high cut-off hemodialysis. Clin J Am Society Nephrol. 2009;4:745-754. https://doi.org/10.2215/CJN.04590908
  24. NCCN Clinical Practice Guidelines in Oncology (NCCN GuidelinesTM) Multiple Myeloma Version 3.2016 http://www.NCCN.org
  25. Laubach J, Garderet L, Mahindra A, Gahrton G, Caers J, Sezer O, Voorhees P, Leleu X, Johnsen H, Streetly M, Jurczyszyn A, Ludwig H, Mellqvist U, Chng W, Pilarski L, Einsele H, Hou J, Turesson I, Zamagni E, Chim C, Mazumder A, Westin J, Lu J, Reiman T, Kristinsson S, Joshua D, Roussel M, O’Gorman P, Terpos E, McCarthy P, Dimopoulos M, Moreau P, Orlowski R, Miguel J, Anderson K, Palumbo A, Kumar S, Rajkumar V, Durie B, Richardson P. Management of relapsed multiple myeloma: recommendations of the International Myeloma Working Group. Leukemia. 2015;30:1005-1017. https://doi.org/10.1038/leu.2015.356
  26. Petrucci M, Giraldo P, Corradini P, Teixeira A, Dimopoulos M, Blau I, Drach J, Angermund R, Allietta N, Broer E, Mitchell V, Bladé J. A prospective, international phase 2 study of bortezomib retreatment in patients with relapsed multiple myeloma. Br J Haematol. 2013;160:649-659. https://doi.org/10.1111/bjh.12198
  27. Knopf K, Duh M, Lafeuille M, Gravel J, Lefebvre P, Niculescu L, Ba-Mancini A, Ma E, Shi H, Comenzo R. Meta-Analysis of the efficacy and safety of bortezomib re-treatment in patients with multiple myeloma. Clin Lymphoma Myeloma and Leuk. 2014;14:380-388. https://doi.org/10.1016/j.clml.2014.03.005
  28. San-Miguel J, Richardson P, Sonneveld P, Schuster M, Irwin D, Stadtmauer E, Facon T, Harousseau J, Ben-Yehuda D, Lonial S, Goldschmidt H, Reece D, Bladé J, Boccadoro M, Cavenagh J, Neuwirth R, Boral A, Esseltine D, Anderson K. Efficacy and safety of bortezomib in patients with renal impairment: results from the APEX phase 3 study. Leukemia. 2008;22:842-849. https://doi.org/10.1038/sj.leu.2405087
  29. Bladé J, Sonneveld P, San Miguel JF, Sutherland HJ, Hajek R, Nagler A, Spencer A, Robak T, Cibeira MT, Zhuang SH, Harousseau JL, Orlowski RZ; Pegylated liposomal doxorubicin plus bortezomib in relapsed or refractory multiple myeloma: Efficacy and safety in patients with renal function impairment. DOXIL-MMY-3001 Study Investigators. Clin Lymphoma Myeloma. 2008.8(6):352-355. https://doi.org/10.3816/CLM.2008.n.051
  30. Dimopoulos M, Alegre A, Stadtmauer EA, Goldschmidt H, Zonder JA, de Castro CM, Masliak Z, Reece D, Olesnyckyj M, Yu Z, Weber DM.The efficacy and safety of lenalidomide plus dexamethasone in relapsed and/or refractory multiple myeloma patients with impaired renal function. Cancer. 2010;116(16):3807-3814. https://doi.org/10.1002/cncr.25139
  31. Dimopoulos MA, Palumbo A, Attal M, Beksaç M, Davies FE, Delforge M, Einsele H, Hajek R, Harousseau JL, da Costa FL, Ludwig H, Mellqvist UH, Morgan GJ, San-Miguel JF, Zweegman S, Sonneveld P;Optimizing the use of lenalidomide in relapsed or refractory multiple myeloma: consensus statement. Leukemia. 2011;25:749-760. https://doi.org/10.1038/leu.2011.3
  32. Klein U, Neben K, Hielscher T, Heiss C, Ho AD, Goldschmidt H. Lenalidomide in combination with dexamethasone: effective regimen in patients with relapsed or refractory multiple myeloma complicated by renal impairment. Ann Hematol. 2011; 90(4):429-439. https://doi.org/10.1007/s00277-010-1080-4
  33. Zhou DB, Yu L, Du X, Jin J, Cai Z, Chen F, Ke X, Li X, Wu D, Meng F, Ai H, Zhang J, DeMarco D, Chen N, Mei J, Wang J, Hou J.Lenalidomide plus low-dose dexamethasone in Chinese patients with relapsed or refractory multiple myeloma and renal impairment. Int J Hematol. 2015;101(6):569-577. https://doi.org/10.1007/s12185-015-1771-7
  34. João C, Freitas J, Gomes F, Geraldes C, Coelho I, Neves M, Lúcio P, Esteves S, Esteves GVLenalidomide is effective and safe for the treatment of patients with relapsed multiple myeloma and very severe renal impairment. Ann Hematol. 2016;95(6):931-936. https://doi.org/10.1007/s00277-016-2662-6

Copyright (c) 2017 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 
 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies