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Kinetics of renal function during induction in newly diagnosed multiple myeloma: results of two prospective studies by the German Myeloma Study Group DSMM

Please always quote using this URN: urn:nbn:de:bvb:20-opus-234139
  • Background: Preservation of kidney function in newly diagnosed (ND) multiple myeloma (MM) helps to prevent excess toxicity. Patients (pts) from two prospective trials were analyzed, provided postinduction (PInd) restaging was performed. Pts received three cycles with bortezomib (btz), cyclophosphamide, and dexamethasone (dex; VCD) or btz, lenalidomide (len), and dex (VRd) or len, adriamycin, and dex (RAD). The minimum required estimated glomerular filtration rate (eGFR) was >30 mL/min. We analyzed the percent change of the renal function usingBackground: Preservation of kidney function in newly diagnosed (ND) multiple myeloma (MM) helps to prevent excess toxicity. Patients (pts) from two prospective trials were analyzed, provided postinduction (PInd) restaging was performed. Pts received three cycles with bortezomib (btz), cyclophosphamide, and dexamethasone (dex; VCD) or btz, lenalidomide (len), and dex (VRd) or len, adriamycin, and dex (RAD). The minimum required estimated glomerular filtration rate (eGFR) was >30 mL/min. We analyzed the percent change of the renal function using the International Myeloma Working Group (IMWG) criteria and Kidney Disease: Improving Global Outcomes (KDIGO)-defined categories. Results: Seven hundred and seventy-two patients were eligible. Three hundred and fifty-six received VCD, 214 VRd, and 202 RAD. VCD patients had the best baseline eGFR. The proportion of pts with eGFR <45 mL/min decreased from 7.3% at baseline to 1.9% PInd (p < 0.0001). Thirty-seven point one percent of VCD versus 49% of VRd patients had a decrease of GFR (p = 0.0872). IMWG-defined “renal complete response (CRrenal)” was achieved in 17/25 (68%) pts after VCD, 12/19 (63%) after RAD, and 14/27 (52%) after VRd (p = 0.4747). Conclusions: Analyzing a large and representative newly diagnosed myeloma (NDMM) group, we found no difference in CRrenal that occurred independently from the myeloma response across the three regimens. A trend towards deterioration of the renal function with VRd versus VCD may be explained by a better pretreatment “renal fitness” in the latter group.show moreshow less

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Metadaten
Author: Friederike Bachmann, Martin Schreder, Monika Engelhardt, Christian Langer, Denise Wolleschak, Lars Olof Mügge, Heinz Dürk, Kerstin Schäfer-Eckart, Igor Wolfgang Blau, Martin Gramatzki, Peter Liebisch, Matthias Grube, Ivana v. Metzler, Florian Bassermann, Bernd Metzner, Christoph Röllig, Bernd Hertenstein, Cyrus Khandanpour, Tobias Dechow, Holger Hebart, Wolfram Jung, Sebastian Theurich, Georg Maschmeyer, Hans Salwender, Georg Hess, Max Bittrich, Leo Rasche, Annamaria Brioli, Kai-Uwe Eckardt, Christian Straka, Swantje Held, Hermann Einsele, Stefan Knop
URN:urn:nbn:de:bvb:20-opus-234139
Document Type:Journal article
Faculties:Medizinische Fakultät / Medizinische Klinik und Poliklinik II
Language:English
Parent Title (English):Cancers
ISSN:2072-6694
Year of Completion:2021
Volume:13
Issue:6
Article Number:1322
Source:Cancers (2021) 13:6, 1322. https://doi.org/10.3390/cancers13061322
DOI:https://doi.org/10.3390/cancers13061322
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Tag:bortezomib; induction regimen; kidney; lenalidomide; multiple myeloma; renal failure
Release Date:2022/07/25
Date of first Publication:2021/03/16
Licence (German):License LogoCC BY: Creative-Commons-Lizenz: Namensnennung 4.0 International