Τίτλος:
Hematologic and renal improvement of monoclonal immunoglobulin deposition disease after treatment with bortezomib-based regimens
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Ziogas, D.C.
Kastritis, E.
Terpos, E.
Roussou, M.
Migkou, M.
Gavriatopoulou, M.
Spanomichou, D.
Eleutherakis-Papaiakovou, E.
Fotiou, D.
Panagiotidis, I.
Kafantari, E.
Psimenou, E.
Boletis, I.
Vlahakos, D.V.
Gakiopoulou, H.
Matsouka, C.
Dimopoulos, M.A.
Περιοδικό:
Clinical Lymphoma Myeloma and Leukemia
Εκδότης:
Taylor and Francis Ltd.
Λέξεις-κλειδιά:
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
DOI:
10.1080/10428194.2016.1267349
