Multiple Myeloma and Renal Failure

*Patrizia Tosi, Manuela Imola, Anna Maria Mianulli,  Simona Tomassetti, Annalia Molinari, Serena Mangianti,  Marina Ratta, Anna Merli, Valentina Polli

Hematology Unit, Department of Oncology and Hematology, Infermi Hospital, Rimini, Italy
*Correspondence to patrizia.tosi@auslrn.net

Disclosure: No potential conflict of interest.
Received: 04.11.14 Accepted: 30.12.14
Citation: EMJ Oncol. 2015;3[1]:65-69.

Abstract

Renal failure (RF) occurs in approximately 20-30% of multiple myeloma (MM) patients at diagnosis and in more than 50% of patients with advanced disease. The pathogenesis of RF is related to the production of monoclonal light chains that can damage either the tubule (myeloma kidney) or the glomeruli (light chain deposition disease or amyloid light-chain amyloidosis). In the past, the prognosis of patients with  MM and RF was considered poor due to the limited number of effective and non-nephrotoxic drugs that were available. At present, novel drugs acting both on MM clone and on bone marrow microenvironment have been introduced into clinical practice; among them, bortezomib-containing regimens have proved  to be the most effective. High-dose myeloablative therapy followed by autologous stem cell rescue can  also be proposed in younger patients with no other relevant comorbidities.

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