Skip to main content
Erschienen in: Irish Journal of Medical Science (1971 -) 2/2024

28.09.2023 | Original Article

Real-life experience with plasmapheresis in newly diagnosed multiple myeloma accompanied by acute kidney injury

verfasst von: Pusem Patir, Gulay Cetin, Sait Emir Sahin, Ozan Palak, Fatma Aykas, Ayca Inci, Volkan Karakus, Erdal Kurtoglu

Erschienen in: Irish Journal of Medical Science (1971 -) | Ausgabe 2/2024

Einloggen, um Zugang zu erhalten

Abstract

Objectives

The aim of this study was to retrospectively evaluate the effect of plasmapheresis treatment concomitant with chemotherapy and the number of sessions on renal improvement and survival in patients with newly diagnosed multiple myeloma (MM) presenting with acute kidney injury (AKI).

Material and methods

Retrospective analysis was performed on 55 newly diagnosed MM patients who were presented with AKI to the Hematology Clinic of University of the Health Sciences Antalya Training and Research Hospital between 2013 and 2021.

Results

The study included 55 patients between 39 and 91 years of age and comprised 22 (40%) women and 33 (60%) men. Forty-eight (87.3%) patients were treated with plasmapheresis and chemotherapy. Based on the median number of plasmapheresis sessions, the patients were grouped as ≤ 3 and > 3. A significant difference was observed in both groups between the mean values of repeated measurements at the time of diagnosis, after completion of plasmapheresis treatment, and at 1 month of plasmapheresis, when statistics of differences were evaluated for urea, creatinine, estimated glomerular filtration rate (eGFR) (ml/min), total protein, albumin, and globulin (p < 0.05); however, there was no difference between these parameters and the number of plasmapheresis sessions. The 1.16 (0.56–2.38) fold higher risk of ex found in patients with ≤ 3 plasmapheresis sessions compared to those with > 3 was not statistically significant (p > 0.05).

Conclusion

It was observed that plasmapheresis is beneficial in the short term for renal recovery in the treatment of MM with AKI and that > 3 plasmapheresis sessions have no superior effectiveness in renal improvement or survival.
Literatur
1.
Zurück zum Zitat Connelly-Smith LS, Linenberger ML (2015) Therapeutic apheresis for patients with cancer. Cancer Control 22:60–78CrossRefPubMed Connelly-Smith LS, Linenberger ML (2015) Therapeutic apheresis for patients with cancer. Cancer Control 22:60–78CrossRefPubMed
2.
Zurück zum Zitat Dimopoulos MA, Kastritis E, Rosinol L et al (2008) Pathogenesis and treatment of renal failure in multiple myeloma. Leukemia 22:1485–93 Dimopoulos MA, Kastritis E, Rosinol L et al (2008) Pathogenesis and treatment of renal failure in multiple myeloma. Leukemia 22:1485–93
3.
Zurück zum Zitat Hutchison CA, Batuman V, Behrens J et al (2011) The pathogenesis and diagnosis of acute kidney injury in multiple myeloma. Nat Rev Nephrol 8(1):43–51CrossRefPubMedPubMedCentral Hutchison CA, Batuman V, Behrens J et al (2011) The pathogenesis and diagnosis of acute kidney injury in multiple myeloma. Nat Rev Nephrol 8(1):43–51CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Chanan-Khan AA, San Miguel JF, Jagannath S et al (2012) Novel therapeutic agents for the management of patients with multiple myeloma and renal impairment. Clin Cancer Res 18:2145–2163CrossRefPubMed Chanan-Khan AA, San Miguel JF, Jagannath S et al (2012) Novel therapeutic agents for the management of patients with multiple myeloma and renal impairment. Clin Cancer Res 18:2145–2163CrossRefPubMed
5.
Zurück zum Zitat Abbott KC, Agodoa LY (2001) Multiple myeloma and light chain-associated nephropathy in end-stage renal disease in the United States: patient characteristics and survival. Clin Nephrol 56(3):207–210PubMed Abbott KC, Agodoa LY (2001) Multiple myeloma and light chain-associated nephropathy in end-stage renal disease in the United States: patient characteristics and survival. Clin Nephrol 56(3):207–210PubMed
6.
Zurück zum Zitat Uttervall K, Duru AD, Lund J et al (2014) The use of novel drugs can effectively improve response, delay relapse, and enhance overall survival in multiple myeloma patients with renal impairment. PLoS ONE 9(7):e101819 Uttervall K, Duru AD, Lund J et al (2014) The use of novel drugs can effectively improve response, delay relapse, and enhance overall survival in multiple myeloma patients with renal impairment. PLoS ONE 9(7):e101819
7.
Zurück zum Zitat Rodrigues L, Neves M, Sá H et al (2014) Severe acute kidney injury and multiple myeloma: evaluation of kidney and patient prognostic factors. Eur J Intern Med 25:652–656CrossRefPubMed Rodrigues L, Neves M, Sá H et al (2014) Severe acute kidney injury and multiple myeloma: evaluation of kidney and patient prognostic factors. Eur J Intern Med 25:652–656CrossRefPubMed
8.
Zurück zum Zitat Tsakiris DJ, Stel VS, Finne P et al (2012) Incidence and outcome of patients starting renal replacement therapy for end-stage renal disease due to multiple myeloma or light-chain deposit disease: an ERA-EDTA registry study. Nephrol Dial Transplant 25:1200–1206CrossRef Tsakiris DJ, Stel VS, Finne P et al (2012) Incidence and outcome of patients starting renal replacement therapy for end-stage renal disease due to multiple myeloma or light-chain deposit disease: an ERA-EDTA registry study. Nephrol Dial Transplant 25:1200–1206CrossRef
9.
Zurück zum Zitat Reule S, Sexton DJ, Solid CA et al (2013) End-stage renal disease due to multiple myeloma in the United States, 2001–2010. J Am Soc Nephrol 27(5):1487–1494CrossRef Reule S, Sexton DJ, Solid CA et al (2013) End-stage renal disease due to multiple myeloma in the United States, 2001–2010. J Am Soc Nephrol 27(5):1487–1494CrossRef
10.
Zurück zum Zitat Smilde TD, van Veldhuisen DJ, Navis G et al (2006) Drawbacks and prognostic value of formulas estimating renal function in patients with chronic heart failure and systolic dysfunction. Circulation 114:1572–1580CrossRefPubMed Smilde TD, van Veldhuisen DJ, Navis G et al (2006) Drawbacks and prognostic value of formulas estimating renal function in patients with chronic heart failure and systolic dysfunction. Circulation 114:1572–1580CrossRefPubMed
11.
Zurück zum Zitat Norman G (2010) Likert scales, levels of measurement, and the “laws” of statistics. Adv Health Sci Educ 15(5):625–632CrossRef Norman G (2010) Likert scales, levels of measurement, and the “laws” of statistics. Adv Health Sci Educ 15(5):625–632CrossRef
12.
13.
Zurück zum Zitat Zucchelli P, Pasquali S, Cagnoli L, Ferrari G (1988) Controlled plasma exchange trial in acute renal failure due to multiple myeloma. Kidney Int 33(6):1175–1180CrossRefPubMed Zucchelli P, Pasquali S, Cagnoli L, Ferrari G (1988) Controlled plasma exchange trial in acute renal failure due to multiple myeloma. Kidney Int 33(6):1175–1180CrossRefPubMed
14.
Zurück zum Zitat Johnson WJ, Kyle RA, Pineda AA et al (1990) Treatment of renal failure associated with multiple myeloma. Plasmapheresis, hemodialysis, and chemotherapy. Arch Intern Med 150(4):863–869 Johnson WJ, Kyle RA, Pineda AA et al (1990) Treatment of renal failure associated with multiple myeloma. Plasmapheresis, hemodialysis, and chemotherapy. Arch Intern Med 150(4):863–869
15.
Zurück zum Zitat Clark WF, Stewart AK, Rock GA et al (2005) Plasma exchange when myeloma presents as acute renal failure: a randomized, controlled trial. Ann Intern Med 143(11):777–784CrossRefPubMed Clark WF, Stewart AK, Rock GA et al (2005) Plasma exchange when myeloma presents as acute renal failure: a randomized, controlled trial. Ann Intern Med 143(11):777–784CrossRefPubMed
16.
Zurück zum Zitat Connelly-Smith L, Alquist CR, Aqui NA et al (2023) Guidelines on the use of therapeutic apheresis in clinical practice-evidence-based approach from the writing committee of the American Society for Apheresis: the ninth special issue. J Clin Apher 38:77–278CrossRefPubMed Connelly-Smith L, Alquist CR, Aqui NA et al (2023) Guidelines on the use of therapeutic apheresis in clinical practice-evidence-based approach from the writing committee of the American Society for Apheresis: the ninth special issue. J Clin Apher 38:77–278CrossRefPubMed
17.
Zurück zum Zitat Leung N, Gertz MA, Zeldenrust SR et al (2008) Improvement of cast nephropathy with plasma exchange depends on the diagnosis and on the reduction of serum free light chains. Kidney Int 73:1282–1288CrossRefPubMed Leung N, Gertz MA, Zeldenrust SR et al (2008) Improvement of cast nephropathy with plasma exchange depends on the diagnosis and on the reduction of serum free light chains. Kidney Int 73:1282–1288CrossRefPubMed
18.
Zurück zum Zitat Hutchison CA, Cockwell P, Stringer S et al (2011) Early reduction of serum-free light chains associates with renal recovery in myeloma kidney. J Am Soc Nephrol 22:1129–1136CrossRefPubMedPubMedCentral Hutchison CA, Cockwell P, Stringer S et al (2011) Early reduction of serum-free light chains associates with renal recovery in myeloma kidney. J Am Soc Nephrol 22:1129–1136CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Premuzic V, Batinic J, Roncevic P et al (2018) Role of plasmapheresis in the management of acute kidney injury in patients with multiple myeloma: should we abandon it? Ther Apher Dial 22:79–86CrossRefPubMed Premuzic V, Batinic J, Roncevic P et al (2018) Role of plasmapheresis in the management of acute kidney injury in patients with multiple myeloma: should we abandon it? Ther Apher Dial 22:79–86CrossRefPubMed
20.
Zurück zum Zitat Hutchison CA, Cockwell P, Moroz V et al (2019) High cutoff versus high-flux hemodialysis for myeloma cast nephropathy in patients receiving bortezomib-based chemotherapy (EuLITE): a phase 2 randomized controlled trial. Lancet Haematol 6:217–228CrossRef Hutchison CA, Cockwell P, Moroz V et al (2019) High cutoff versus high-flux hemodialysis for myeloma cast nephropathy in patients receiving bortezomib-based chemotherapy (EuLITE): a phase 2 randomized controlled trial. Lancet Haematol 6:217–228CrossRef
Metadaten
Titel
Real-life experience with plasmapheresis in newly diagnosed multiple myeloma accompanied by acute kidney injury
verfasst von
Pusem Patir
Gulay Cetin
Sait Emir Sahin
Ozan Palak
Fatma Aykas
Ayca Inci
Volkan Karakus
Erdal Kurtoglu
Publikationsdatum
28.09.2023
Verlag
Springer International Publishing
Erschienen in
Irish Journal of Medical Science (1971 -) / Ausgabe 2/2024
Print ISSN: 0021-1265
Elektronische ISSN: 1863-4362
DOI
https://doi.org/10.1007/s11845-023-03535-y

Weitere Artikel der Ausgabe 2/2024

Irish Journal of Medical Science (1971 -) 2/2024 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Battle of Experts: Sport vs. Spritze bei Adipositas und Typ-2-Diabetes

11.05.2024 DDG-Jahrestagung 2024 Kongressbericht

Im Battle of Experts traten zwei Experten auf dem Diabeteskongress gegeneinander an: Die eine vertrat die Auffassung „Sport statt Spritze“ bei Adipositas und Typ-2-Diabetes, der andere forderte „Spritze statt Sport!“ Am Ende waren sie sich aber einig: Die Kombination aus beidem erzielt die besten Ergebnisse.

Vorsicht, erhöhte Blutungsgefahr nach PCI!

10.05.2024 Koronare Herzerkrankung Nachrichten

Nach PCI besteht ein erhöhtes Blutungsrisiko, wenn die Behandelten eine verminderte linksventrikuläre Ejektionsfraktion aufweisen. Das Risiko ist umso höher, je stärker die Pumpfunktion eingeschränkt ist.

Triglyzeridsenker schützt nicht nur Hochrisikopatienten

10.05.2024 Hypercholesterinämie Nachrichten

Patienten mit Arteriosklerose-bedingten kardiovaskulären Erkrankungen, die trotz Statineinnahme zu hohe Triglyzeridspiegel haben, profitieren von einer Behandlung mit Icosapent-Ethyl, und zwar unabhängig vom individuellen Risikoprofil.

Gibt es eine Wende bei den bioresorbierbaren Gefäßstützen?

In den USA ist erstmals eine bioresorbierbare Gefäßstütze – auch Scaffold genannt – zur Rekanalisation infrapoplitealer Arterien bei schwerer PAVK zugelassen worden. Das markiert einen Wendepunkt in der Geschichte dieser speziellen Gefäßstützen.

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.