Ερευνητικό υλικό ΕΚΠΑ

International myeloma working group recommendations for the diagnosis and management of myeloma-related renal impairment

Αγγλικά

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.

2016

Dimopoulos, M.A.
Sonneveld, P.
Leung, N.
Merlini, G.
Ludwig, H.
Kastritis, E.
Goldschmidt, H.
Joshua, D.
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Journal of Clinical Oncology

American Society of Clinical Oncology

34

13

1544-1557

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

https://doi.org/10.1200/JCO.2015.65.0044

10.1200/JCO.2015.65.0044

https://pergamos.lib.uoa.gr/uoa/dl/object/3085510