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Nephrol Dial Transplant (2000) 15: 301-304
© 2000 European Renal Association-European Dialysis and Transplant Association

Editorial Comments

Multiple myeloma and renal failure

Hartmut Goldschmidt1, Heinrich Lannert1, Jürgen Bommer2 and Anthony D. Ho1

1 Medizinische Klinik und Poliklinik V and 2 Sektion Nephrologie, Medizinische Klinik und Poliklinik I, Universtität Heidelberg, Heidelberg, Germany

Correspondence and offprint requests to: Anthony D. Ho, Medizinische Klinik und Poliklinik V, Universität Heidelberg, Hospitalstr. 3, 69115 Heidelberg, Germany.

Introduction

Multiple myeloma (MM) is a clonal B-cell disease of slowly proliferating plasma cells, accompanied by monoclonal protein production and lytic bone lesions. Up to 50% of newly diagnosed patients have a decrease in creatine clearance and ~9% require dialysis because of severe renal impairment [1]. Despite progress in polychemotherapy regimens with improvements in response rates, the median survival time with conventional chemotherapy remains no more than 2–3 years [2]. High-dose chemotherapy (HDT) supported by autologous bone marrow or peripheral blood stem-cell transplantation has achieved higher complete remission (CR) rates and prolonged event-free and overall survival [3]. However, patients with renal failure are often excluded from aggressive or high-dose chemotherapy protocols because of an expected higher toxicity rate.

Renal involvement in multiple myeloma

Approximately 20% of the patients with MM will develop progressive renal failure during the course of myeloma disease. Cast nephropathy is a typical renal complication found in . . . [Full Text of this Article]

Management of renal failure in multiple myeloma

Current treatment for multiple myeloma

Therapy of multiple myeloma patients with renal impairment

Conventional chemotherapy
High-dose therapy
Supportive therapies
Conclusion

References


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