1. Kinetics of Renal Function during Induction in Newly Diagnosed Multiple Myeloma: Results of Two Prospective Studies by the German Myeloma Study Group DSMM
- Author
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Martin Gramatzki, Bernd Metzner, Friederike Bachmann, Christian Straka, Annamaria Brioli, Max Bittrich, Martin Schreder, Swantje Held, Hermann Einsele, Hans Salwender, Tobias Dechow, Christoph Röllig, Kai-Uwe Eckardt, Sebastian Theurich, Matthias Grube, Denise Wolleschak, Monika Engelhardt, Kerstin Schäfer-Eckart, Holger Hebart, Bernd Hertenstein, Leo Rasche, Igor Wolfgang Blau, Stefan Knop, Georg Maschmeyer, Wolfram Jung, Cyrus Khandanpour, Lars Olof Mügge, Christian Langer, Peter Liebisch, Florian Bassermann, Ivana von Metzler, Heinz Dürk, and Georg Hess
- Subjects
renal failure ,kidney ,endocrine system ,Cancer Research ,medicine.medical_specialty ,Cyclophosphamide ,030232 urology & nephrology ,Urology ,Renal function ,lcsh:RC254-282 ,Niereninsuffizienz ,Article ,Bortezomib ,03 medical and health sciences ,0302 clinical medicine ,Multiple myeloma ,medicine ,ddc:610 ,Renal insufficiency ,Lenalidomide ,Dexamethasone ,Kidney ,business.industry ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,induction regimen ,medicine.disease ,3. Good health ,medicine.anatomical_structure ,Oncology ,030220 oncology & carcinogenesis ,Plasmozytom ,business ,DDC 610 / Medicine & health ,Kidney disease ,medicine.drug - Abstract
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 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.
- Published
- 2021
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