Difficulties evaluating hematological response in patients with multiple myeloma and dialysis - dependent renal impairment


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Abstract

Aim: to determine serum free light chains (FLC) level by patients with multiple myeloma (MM) and dialysis - dependent renal impairment in which the amount Bence Jones (BJ) protein in the urine met the criteria of hematological response. Patients and methods: This study included 13 MM with dialysis - dependent renal impairment patients (estimated glomerular filtration rate < 10 ml/min), whose urine BJ protein content was less than 200 mg/day after antimyeloma therapy (including 11 patients whose urine BJ protein content was less than 100 mg/day). Results. The median serum concentration of monoclonal FLC was 608.7 (298-8380) mg/l. Thus, with trace amounts BJ protein in the urine serum content monoclonal FLC varied 28 times with the same degree of severity of renal failure. In patients with oliguria serum SLC content was significantly higher than in normal diuresis (1109 and 307 mg/L; p<0.05). Conclusion. Low amount of BJ protein in urine of patients with MM and dialysis - dependent renal impairment can be combined with high concentration of monoclonal FLC in serum. Therefore, the study of FLC in serum is necessary for monitoring MM in this group of patients. It is important to develop clarifying criteria of hematological response in patients with MM and dialysis - dependent renal impairment.

About the authors

I G Rekhtina

National Research Center for Hematology

Email: rekhtina.i@blood.ru
д.м.н., зав. отд-нием химиотерапии плазмоклеточных дискразий ФГБУ «НМИЦ гематологии» Минздрава России; ORCID: 0000-0001-5440-4340 Moscow, Russia

L P Mendeleeva

National Research Center for Hematology

д.м.н., проф., зам. генерального директора по научной работе и инновациям, зав. отд. высокодозной химиотерапии парапротеинемических гемобластозов ФГБУ «НМИЦ гематологии» ГНЦ Минздрава России; ORCID: 0000-0002-4966-8146 Moscow, Russia

N P Soboleva

National Research Center for Hematology

врач клинической лабораторной диагностики центральной клинико-диагностической лаб. ФГБУ «НМИЦ гематологии» Минздрава России; ORCID: 0000-0002-1903-2446 Moscow, Russia

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