TY - JOUR
TI - Hematologic and renal improvement of monoclonal immunoglobulin deposition disease after treatment with bortezomib-based regimens
AU - Ziogas, D.C.
AU - Kastritis, E.
AU - Terpos, E.
AU - Roussou, M.
AU - Migkou, M.
AU - Gavriatopoulou, M.
AU - Spanomichou, D.
AU - Eleutherakis-Papaiakovou, E.
AU - Fotiou, D.
AU - Panagiotidis, I.
AU - Kafantari, E.
AU - Psimenou, E.
AU - Boletis, I.
AU - Vlahakos, D.V.
AU - Gakiopoulou, H.
AU - Matsouka, C.
AU - Dimopoulos, M.A.
JO - Clinical Lymphoma Myeloma and Leukemia
PY - 2017
VL - 58
TODO - 8
SP - 1832-1839
PB - Taylor and Francis Ltd.
SN - null
TODO - 10.1080/10428194.2016.1267349
TODO - bortezomib;  cyclophosphamide;  dexamethasone;  immunoglobulin deposition;  monoclonal immunoglobulin deposition disease;  paraprotein;  antineoplastic agent;  biological marker;  bortezomib;  immunoglobulin heavy chain;  immunoglobulin light chain, adult;  aged;  amyloidosis;  Article;  clinical article;  dialysis;  electron microscopy;  end stage renal disease;  estimated glomerular filtration rate;  female;  fibrosing alveolitis;  human;  hypertension;  immunoglobulin deposition;  light chain deposition disease;  male;  monoclonal immunoglobulin deposition disease;  monoclonal immunoglobulin deposition disease;  prognosis;  protein electrophoresis;  proteinuria;  remission;  treatment outcome;  biopsy;  blood;  complication;  hematologic disease;  kidney disease;  kidney function test;  metabolism;  middle aged;  mortality;  paraproteinemia;  pathophysiology;  very elderly, Aged;  Aged, 80 and over;  Antineoplastic Combined Chemotherapy Protocols;  Biomarkers;  Biopsy;  Bortezomib;  Female;  Hematologic Diseases;  Humans;  Immunoglobulin Heavy Chains;  Immunoglobulin Light Chains;  Kidney Diseases;  Kidney Function Tests;  Male;  Middle Aged;  Paraproteinemias;  Treatment Outcome
TODO - Monoclonal immunoglobulin deposition disease (MIDD) is characterized by non-organized immunoglobulin-fragments along renal basement membranes with subsequent organ deterioration. Treatment is directed against the immunoglobulin-producing clone. We treated 18 MIDD patients with bortezomib-based regimens (12 received bortezomib-dexamethasone, 6 bortezomib-dexamethasone with cyclophosphamide). Eleven (61%) patients achieved a hematologic response, but only 6 (33.3%) reached to a complete (CR) or very good partial response (VGPR). Regarding renal outcomes 77.8 and 55.6% had ≥30 and ≥50% reduction of proteinuria, respectively, but 33.3% ended up in end-stage renal disease (ESRD). Among patients with CR or VGPR, median eGFR improvement was 7.7 ml/min/1.73 m2 and none progressed to ESRD, but no significant renal recovery was observed in patients achieving a partial response or less, with 50% progressing to dialysis. Pretreatment eGFR seems to influence renal prognosis. Bortezomib-based treatment is considered an effective approach in MIDD and reaching to a deep hematologic response (≥VGPR) conditionally controls further renal declining. © 2016 Informa UK Limited, trading as Taylor & Francis Group.
ER -