Improvement in renal function and its impact on survival in patients with newly diagnosed multiple myeloma

W. I. Gonsalves, N. Leung, S. V. Rajkumar, A. Dispenzieri, M. Q. Lacy, S. R. Hayman, F. K. Buadi, D. Dingli, P. Kapoor, R. S. Go, Y. Lin, S. J. Russell, J. A. Lust, S. Zeldenrust, R. A. Kyle, M. A. Gertz, S. K. Kumar

Research output: Contribution to journalArticle

48 Scopus citations

Abstract

Renal impairment (RI) is seen in over a quarter of patients with newly diagnosed multiple myeloma (NDMM). It is not clear if reversal of RI improves the outcome to that expected for NDMM patients without RI. We evaluated 1135 consecutive patients with NDMM seen at the Mayo Clinic between January 2003 and December 2012. RI was defined as having a creatinine clearance (CrCl) o40ml/min. The median overall survival (OS) for patients with RI at diagnosis receiving and not receiving novel agent induction therapy was not reached vs 46 months (Po0.001). The median OS for patients with CrCl ≥ 40 ml/min at diagnosis, CrCl o40 ml/ min at diagnosis but improved to ≥40 ml/min and CrCl o40 ml/min at diagnosis and remained o40 ml/min, were 112, 56 and 33 months, respectively (Po0.001). The complete renal response rate for patients with RI at diagnosis receiving novel agent induction therapy compared to the rest was 40 vs 16% (Po0.001). In conclusion, patients with reversal of RI have improved outcomes, but it remains inferior to patients with normal renal function at diagnosis. These results have implications for identifying early treatment strategies for patients at risk of developing renal insufficiency.

Original languageEnglish (US)
Article numbere296
JournalBlood cancer journal
Volume5
Issue number3
DOIs
StatePublished - Mar 20 2015

ASJC Scopus subject areas

  • Hematology
  • Oncology

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