Renal Dysfunction and Recovery following Initial Treatment of Newly Diagnosed Multiple Myeloma

Introduction. Renal insufficiency (RI) in Multiple Myeloma (MM) portends a higher tumor burden and worse prognosis. Reversal of RI in newly diagnosed MM (NDMM) improves patient outcomes, but it is unknown if there is a disparity in renal recovery in NDMM between African Americans (AA) and non-Africa...

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Main Authors: Benjamin A. Derman, Jochen Reiser, Sanjib Basu, Agne Paner
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:International Journal of Nephrology
Online Access:http://dx.doi.org/10.1155/2018/4654717
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author Benjamin A. Derman
Jochen Reiser
Sanjib Basu
Agne Paner
author_facet Benjamin A. Derman
Jochen Reiser
Sanjib Basu
Agne Paner
author_sort Benjamin A. Derman
collection DOAJ
description Introduction. Renal insufficiency (RI) in Multiple Myeloma (MM) portends a higher tumor burden and worse prognosis. Reversal of RI in newly diagnosed MM (NDMM) improves patient outcomes, but it is unknown if there is a disparity in renal recovery in NDMM between African Americans (AA) and non-African Americans. Methods. A retrospective chart review was conducted of 690 patients with NDMM at Rush University Medical Center from 2005 to 2016. 118 patients (59 AA and 59 non-AA) with NDMM and an estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73 m2 at the time of diagnosis were identified and analyzed. The time to best renal response and best eGFR achieved during initial myeloma therapy were tabulated. Results. Median eGFR at the time of diagnosis was similar between the AA and non-AA groups (47.89 versus 51.95, p=0.56). Median absolute change in eGFR after initial therapy was significantly higher in the AA (+33.64) versus the non-AA group (+21.07, p=0.00183). This difference remained whether the baseline eGFR at diagnosis was <90 or <60 mL/min/1.73 m2. Discussion. AA patients with NDMM treated in the era of novel agents have greater improvement in renal function in comparison to non-AA patients, regardless of myeloma response. The biological underpinnings for this disparity require further investigation.
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spelling doaj-art-bb73fcf0b0684d928b4bc2e55b97e83b2025-02-03T01:07:12ZengWileyInternational Journal of Nephrology2090-214X2090-21582018-01-01201810.1155/2018/46547174654717Renal Dysfunction and Recovery following Initial Treatment of Newly Diagnosed Multiple MyelomaBenjamin A. Derman0Jochen Reiser1Sanjib Basu2Agne Paner3Section of Hematology/Oncology, University of Chicago, 5841 S. Maryland Ave, M/C 2115, Chicago, IL 60637, USADepartment of Medicine, Rush University Medical Center, Chicago, IL, USADivision of Hematology/Oncology, Rush University Medical Center, Chicago, IL, USADivision of Hematology/Oncology, Rush University Medical Center, Chicago, IL, USAIntroduction. Renal insufficiency (RI) in Multiple Myeloma (MM) portends a higher tumor burden and worse prognosis. Reversal of RI in newly diagnosed MM (NDMM) improves patient outcomes, but it is unknown if there is a disparity in renal recovery in NDMM between African Americans (AA) and non-African Americans. Methods. A retrospective chart review was conducted of 690 patients with NDMM at Rush University Medical Center from 2005 to 2016. 118 patients (59 AA and 59 non-AA) with NDMM and an estimated glomerular filtration rate (eGFR) < 90 mL/min/1.73 m2 at the time of diagnosis were identified and analyzed. The time to best renal response and best eGFR achieved during initial myeloma therapy were tabulated. Results. Median eGFR at the time of diagnosis was similar between the AA and non-AA groups (47.89 versus 51.95, p=0.56). Median absolute change in eGFR after initial therapy was significantly higher in the AA (+33.64) versus the non-AA group (+21.07, p=0.00183). This difference remained whether the baseline eGFR at diagnosis was <90 or <60 mL/min/1.73 m2. Discussion. AA patients with NDMM treated in the era of novel agents have greater improvement in renal function in comparison to non-AA patients, regardless of myeloma response. The biological underpinnings for this disparity require further investigation.http://dx.doi.org/10.1155/2018/4654717
spellingShingle Benjamin A. Derman
Jochen Reiser
Sanjib Basu
Agne Paner
Renal Dysfunction and Recovery following Initial Treatment of Newly Diagnosed Multiple Myeloma
International Journal of Nephrology
title Renal Dysfunction and Recovery following Initial Treatment of Newly Diagnosed Multiple Myeloma
title_full Renal Dysfunction and Recovery following Initial Treatment of Newly Diagnosed Multiple Myeloma
title_fullStr Renal Dysfunction and Recovery following Initial Treatment of Newly Diagnosed Multiple Myeloma
title_full_unstemmed Renal Dysfunction and Recovery following Initial Treatment of Newly Diagnosed Multiple Myeloma
title_short Renal Dysfunction and Recovery following Initial Treatment of Newly Diagnosed Multiple Myeloma
title_sort renal dysfunction and recovery following initial treatment of newly diagnosed multiple myeloma
url http://dx.doi.org/10.1155/2018/4654717
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AT jochenreiser renaldysfunctionandrecoveryfollowinginitialtreatmentofnewlydiagnosedmultiplemyeloma
AT sanjibbasu renaldysfunctionandrecoveryfollowinginitialtreatmentofnewlydiagnosedmultiplemyeloma
AT agnepaner renaldysfunctionandrecoveryfollowinginitialtreatmentofnewlydiagnosedmultiplemyeloma