Τίτλος:
Carfilzomib-associated renal toxicity is common and unpredictable: a comprehensive analysis of 114 multiple myeloma patients
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Carfilzomib (CFZ) is a non-reversible proteasome inhibitor approved for the treatment of patients with relapsed and refractory myeloma (RRMM). Its use has been associated with cardiovascular toxicity but although recently a signal of clinically significant renal complications has also been identified, it is less extensively investigated. We analyzed data of 114 consecutive patients with RRMM who received CFZ-based regimens. Renal complications not related to MM progression were observed in 19 (17%) patients; thrombotic microangiopathy (TMA) was seen in 6 (5%) patients, albuminuria >1 gr/day in 7 patients (6%) and at least grade 3 acute kidney injury (AKI) which could not be otherwise explained in 6 patients (5%). A total of 15 patients discontinued CFZ and dosing was reinitiated at a lower level in one patient with AKI. Albuminuria was associated with focal segmental glomerulosclerosis in the renal biopsy (performed in a total of 6 patients). Renal complications during CFZ therapy are common, occur mostly early and are unpredictable. A potential effect of CFZ on the renal endothelium could be implicated in the pathogenesis of these complications and may also share common pathophysiology with cardiovascular effects of CFZ. © 2020, The Author(s).
Συγγραφείς:
Fotiou, D.
Roussou, M.
Gakiopoulou, C.
Psimenou, E.
Gavriatopoulou, M.
Migkou, M.
Kanellias, N.
Dialoupi, I.
Eleutherakis-Papaiakovou, E.
Giannouli, S.
Delavinia, C.
Efstathiou, K.
Kontogiannis, S.
Terpos, E.
Dimopoulos, M.A.
Kastritis, E.
Περιοδικό:
Blood cancer journal
Εκδότης:
Springer Nature BV
Λέξεις-κλειδιά:
carfilzomib; carfilzomib; oligopeptide, acute kidney failure; adult; aged; albuminuria; Article; cancer patient; cancer resistance; cardiovascular effect; endothelium; female; focal glomerulosclerosis; human; human tissue; kidney biopsy; major clinical study; male; multiple myeloma; nephrotoxicity; thrombotic thrombocytopenic purpura; acute kidney failure; albuminuria; clinical trial; focal glomerulosclerosis; middle aged; multiple myeloma; very elderly, Acute Kidney Injury; Adult; Aged; Aged, 80 and over; Albuminuria; Female; Glomerulosclerosis, Focal Segmental; Humans; Male; Middle Aged; Multiple Myeloma; Oligopeptides
DOI:
10.1038/s41408-020-00381-4
