@article{3085510,
    title = "International myeloma working group recommendations for the diagnosis and management of myeloma-related renal impairment",
    author = "Dimopoulos, M.A. and Sonneveld, P. and Leung, N. and Merlini, G. and Ludwig, H. and Kastritis, E. and Goldschmidt, H. and Joshua, D. and Orlowski, R.Z. and Powles, R. and Vesole, D.H. and Garderet, L. and Einsele, H. and Palumbo, A. and Cavo, M. and Richardson, P.G. and Moreau, P. and Miguel, J.S. and Vincent Rajkumar, S. and Durie, B.G.M. and Terpos, E. and Abildgaard, N. and Abonour, R. and Alsina, M. and Anderson, K.C. and Attal, M. and Avet-Loiseau, H. and Badros, A. and Bahlis, N.J. and Barlogie, B. and Bataille, R. and Beksaç, M. and Belch, A. and Ben-Yehuda, D. and Bensinger, B. and Leif Bergsagel, P. and Bhutani, M. and Bird, J. and Bladé, J. and Broijl, A. and Boccadoro, M. and Caers, J. and Chanan-Khan, A. and Chari, A. and Chen, W.M. and Chesi, M. and Anthony Child, J. and Chim, C.S. and Chng, W.-J. and Comenzo, R. and Cook, G. and Crowley, J. and Crusoe, E. and Dalton, W. and Lee Moffitt, H. and Davies, F. and de la Rubia, J. and de Souza, C. and Delforge, M. and Dhodapkar, M. and Dispenzieri, A. and Drach, J. and Drake, M. and Du, J. and Dytfeld, D. and Facon, T. and Fantl, D. and Fermand, J.-P. and Fernández de Larrea, C. and Fonseca, R. and Gahrton, G. and Garćia-Sanz, R. and Gasparetto, C. and Gertz, M. and Ghobrial, I. and Gibson, J. and Gimsing, P. and Giralt, S. and Gu, J. and Hajek, R. and Hardan, I. and Hari, P. and Hata, H. and Hattori, Y. and Heffner, T. and Hillengass, J. and Ho, J. and Hoering, A. and Hoffman, J.E. and Hou, J. and Huang, J. and Hungria, V. and Ida, S. and Jagannath, S. and Jakubowiak, A.J. and Johnsen, H.E. and Jurczyszyn, A. and Kaiser, M. and Kaufman, J. and Kawano, M. and Korde, N. and Kovacs, E. and Krishnan, A. and Kristinsson, S. and Kröger, N. and Kumar, S. and Kyle, R.A. and Kyriacou, C. and Lacy, M. and Lahuerta, J.J. and Landgren, O. and Larocca, A. and Laubach, J. and da Costa, F.L. and Lee, J.-H. and Leiba, M. and Leleu, X. and Lentzsch, S. and Lokhorst, H. and Lonial, S. and Lu, J. and Mahindra, A. and Maiolino, A. and Manasanch, E.E. and Mark, T. and Mateos, M.-V. and Mazumder, A. and McCarthy, P. and Mehta, J. and Mellqvist, U.-H. and Mikhael, J. and Morgan, G. and Munshi, N. and Nahi, H. and Nawarawong, W. and Niesvizky, R. and Nouel, A. and Novis, Y. and Ocio, E. and O'Dwyer, M. and O'Gorman, P. and Orfao, A. and Otero, P.R. and Paiva, B. and Pavlovsky, S. and Pilarski, L. and Pratt, G. and Qui, L. and Raje, N. and Reece, D. and Reiman, A. and Remaggi, G. and Richter, J. and Serra, E.R. and Morales, A.R. and Romeril, K.R. and Roodman, D. and Rosiñol, L. and Rossi, A. and Roussel, M. and Russell, S. and Schjesvold, F. and Schots, R. and Sevcikova, S. and Sezer, O. and Shah, J.J. and Shimizu, K. and Shustik, C. and Siegel, D. and Singhal, S. and Spencer, A. and Stadtmauer, E. and Stewart, K. and Tan, D. and Terragna, C. and Tosi, P. and Tricot, G. and Turesson, I. and Usmani, S. and Van Camp, B. and Van de Donk, N. and Van Ness, B. and Van Riet, I. and Broek, I.V. and Vanderkerken, K. and Vescio, R. and Vij, R. and Voorhees, P. and Waage, A. and Wang, M. and Weber, D. and Weiss, B.M. and Westin, J. and Wheatley, K. and Zamagni, E. and Zonder, J. and Zweegman, S.",
    journal = "Journal of Clinical Oncology",
    year = "2016",
    volume = "34",
    number = "13",
    pages = "1544-1557",
    publisher = "American Society of Clinical Oncology",
    issn = "0732-183X, 1527-7755",
    doi = "10.1200/JCO.2015.65.0044",
    keywords = "bortezomib;  carfilzomib;  creatinine;  cyclophosphamide;  dexamethasone;  doxorubicin;  electrolyte;  ixazomib;  lenalidomide;  melphalan;  pomalidomide;  thalidomide, Article;  autologous stem cell transplantation;  cancer combination chemotherapy;  creatinine blood level;  creatinine clearance;  dialysis membrane;  disease assessment;  drug dose reduction;  drug megadose;  feasibility study;  glomerulus filtration rate;  human;  kidney biopsy;  kidney function;  light chain;  mild renal impairment;  moderate renal impairment;  multiple myeloma;  pathophysiology;  priority journal;  treatment response;  tumor diagnosis;  multiple myeloma;  Renal Insufficiency, Humans;  Multiple Myeloma;  Renal Insufficiency",
    abstract = "Purpose: The aim of the International Myeloma Working Group was to develop practical recommendations for the diagnosis and management of multiple myeloma–related renal impairment (RI). Methods: Recommendations were based on published data through December 2015, and were developed using the system developed by the Grading of Recommendation, Assessment, Development, and Evaluation Working Group. Recommendations: All patients with myeloma at diagnosis and at disease assessment should have serum creatinine, estimated glomerular filtration rate, and electrolytes measurements as well as free light chain, if available, and urine electrophoresis of a sample from a 24-hour urine collection (grade A). The Chronic Kidney Disease Epidemiology Collaboration, preferably, or the Modification of Diet in Renal Disease formula should be used for the evaluation of estimated glomerular filtration rate in patients with stabilized serum creatinine (grade A). International Myeloma Working Group criteria for renal reversibility should be used (grade B). For the management of RI in patients with multiple myeloma, high fluid intake is indicated along with antimyeloma therapy (grade B). The use of high-cutoff hemodialysis membranes in combination with antimyeloma therapy can be considered (grade B). Bortezomib-based regimens remain the cornerstone of the management of myeloma-related RI (grade A). High-dose dexamethasone should be administered at least for the first month of therapy (grade B). Thalidomide is effective in patients with myeloma with RI, and no dose modifications are needed (grade B). Lenalidomide is effective and safe, mainly in patients with mild to moderate RI (grade B); for patients with severe RI or on dialysis, lena-lidomide should be given with close monitoring for hematologic toxicity (grade B) with dose reduction as needed. High-dose therapy with autologous stem cell transplantation (with melphalan 100 mg/m2 to 140 mg/m2) is feasible in patients with RI (grade C). Carfilzomib can be safely administered to patients with creatinine clearance > 15 mL/min, whereas ixazomib in combination with lenalidomide and dex-amethasone can be safely administered to patients with creatinine clearance > 30 mL/min (grade A). © 2016 by American Society of Clinical Oncology."
}