Clinical and prognostic differences among patients with light chain deposition disease, myeloma cast nephropathy and both

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Abstract

In some patients with light chain deposition disease (LCDD) there is also evidence of myeloma cast nephropathy (MCN) on renal biopsy. The purpose of this study was to evaluate the renal and survival outcome of patients with concomitant diagnosis of MCN and LCDD to LCDD and MCN alone. Eighty seven patients were identified and divided into LCDD (n = 45), MCN (n = 29), and LCDD+ MCN (n = 13). Patients with LCDD+ MCN had a worse overall survival (OS) compared to patients with LCDD (p = 0.03), but similar to patients with MCN (p = 0.4). Death-censored renal survival was no different amongst the groups. Presenting with acute renal failure at time of renal biopsy (HR 7.2, p = 0.0002) was an independent poor renal prognostic factor while older age (HR 1.06, p = 0.0002), presence of osteolytic lesions (HR 4.4, p <0.0001), and requirement for dialysis or creatinine ≥ 5 mg/dL (HR 3.2, p = 0.0006) at time of renal biopsy were independent poor prognostic factors for OS.

Original languageEnglish (US)
Pages (from-to)3357-3364
Number of pages8
JournalLeukemia and Lymphoma
Volume56
Issue number12
DOIs
StatePublished - Dec 2 2015

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Light
Kidney
Biopsy
Survival
Acute Kidney Injury
Dialysis
Creatinine

Keywords

  • Light chain deposition disease
  • multiple myeloma
  • myeloma cast nephropathy
  • renal disease

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Cancer Research

Cite this

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title = "Clinical and prognostic differences among patients with light chain deposition disease, myeloma cast nephropathy and both",
abstract = "In some patients with light chain deposition disease (LCDD) there is also evidence of myeloma cast nephropathy (MCN) on renal biopsy. The purpose of this study was to evaluate the renal and survival outcome of patients with concomitant diagnosis of MCN and LCDD to LCDD and MCN alone. Eighty seven patients were identified and divided into LCDD (n = 45), MCN (n = 29), and LCDD+ MCN (n = 13). Patients with LCDD+ MCN had a worse overall survival (OS) compared to patients with LCDD (p = 0.03), but similar to patients with MCN (p = 0.4). Death-censored renal survival was no different amongst the groups. Presenting with acute renal failure at time of renal biopsy (HR 7.2, p = 0.0002) was an independent poor renal prognostic factor while older age (HR 1.06, p = 0.0002), presence of osteolytic lesions (HR 4.4, p <0.0001), and requirement for dialysis or creatinine ≥ 5 mg/dL (HR 3.2, p = 0.0006) at time of renal biopsy were independent poor prognostic factors for OS.",
keywords = "Light chain deposition disease, multiple myeloma, myeloma cast nephropathy, renal disease",
author = "Ladan Zand and Nasr, {Samih H.} and Morie Gertz and Angela Dispenzieri and Martha Lacy and Buadi, {Francis K.} and Kumar, {Shaji K} and Kyle, {Robert A.} and Fervenza, {Fernando Custodio} and Sethi, {Sanjeev M} and Dingli, {David M} and Rajkumar, {S Vincent} and Prashant Kapoor and Arleigh McCurdy and Nelson Leung",
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T1 - Clinical and prognostic differences among patients with light chain deposition disease, myeloma cast nephropathy and both

AU - Zand, Ladan

AU - Nasr, Samih H.

AU - Gertz, Morie

AU - Dispenzieri, Angela

AU - Lacy, Martha

AU - Buadi, Francis K.

AU - Kumar, Shaji K

AU - Kyle, Robert A.

AU - Fervenza, Fernando Custodio

AU - Sethi, Sanjeev M

AU - Dingli, David M

AU - Rajkumar, S Vincent

AU - Kapoor, Prashant

AU - McCurdy, Arleigh

AU - Leung, Nelson

PY - 2015/12/2

Y1 - 2015/12/2

N2 - In some patients with light chain deposition disease (LCDD) there is also evidence of myeloma cast nephropathy (MCN) on renal biopsy. The purpose of this study was to evaluate the renal and survival outcome of patients with concomitant diagnosis of MCN and LCDD to LCDD and MCN alone. Eighty seven patients were identified and divided into LCDD (n = 45), MCN (n = 29), and LCDD+ MCN (n = 13). Patients with LCDD+ MCN had a worse overall survival (OS) compared to patients with LCDD (p = 0.03), but similar to patients with MCN (p = 0.4). Death-censored renal survival was no different amongst the groups. Presenting with acute renal failure at time of renal biopsy (HR 7.2, p = 0.0002) was an independent poor renal prognostic factor while older age (HR 1.06, p = 0.0002), presence of osteolytic lesions (HR 4.4, p <0.0001), and requirement for dialysis or creatinine ≥ 5 mg/dL (HR 3.2, p = 0.0006) at time of renal biopsy were independent poor prognostic factors for OS.

AB - In some patients with light chain deposition disease (LCDD) there is also evidence of myeloma cast nephropathy (MCN) on renal biopsy. The purpose of this study was to evaluate the renal and survival outcome of patients with concomitant diagnosis of MCN and LCDD to LCDD and MCN alone. Eighty seven patients were identified and divided into LCDD (n = 45), MCN (n = 29), and LCDD+ MCN (n = 13). Patients with LCDD+ MCN had a worse overall survival (OS) compared to patients with LCDD (p = 0.03), but similar to patients with MCN (p = 0.4). Death-censored renal survival was no different amongst the groups. Presenting with acute renal failure at time of renal biopsy (HR 7.2, p = 0.0002) was an independent poor renal prognostic factor while older age (HR 1.06, p = 0.0002), presence of osteolytic lesions (HR 4.4, p <0.0001), and requirement for dialysis or creatinine ≥ 5 mg/dL (HR 3.2, p = 0.0006) at time of renal biopsy were independent poor prognostic factors for OS.

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