BACKGROUND: Renal impairment (RI) is a common presenting complication of multiple myeloma (MM); the availability of new treatments has improved the outcomes of patients with MM; however, their impact on the survival of patients who present with RI has not been extensively studied. PATIENTS AND METHODS: We analyzed the characteristics and outcomes of 1773 consecutive unselected patients who were treated for symptomatic myeloma since January 1990. RESULTS: Although there was a significant increase in the proportion of patients of advanced age in the more recent periods, the frequency of RI as well as the proportion of patients who presented with severe RI (eGFR < 30 ml/min/1.73 m(2)) remained unchanged around 18%. Thus, after adjustment for age, there was a decrease in the risk of severe RI at presentation after 2000. Myeloma response rates (≥PR) to frontline therapy have substantially increased, and this was translated in a significant increase in the median survival. Specifically for patients with severe RI, the median OS has improved from 18 and 19.5 months in the 1990-1994 and 1995-1999 to 29 and 32 months for the periods 2000-2004 and after 2005 (P = 0.005). Severe RI was associated with a high risk of early death (12% versus 7% for patients with moderate RI versus 3% for patients with mild or no RI (P < 0.001), especially among older patients, and has remained unchanged over time. CONCLUSIONS: There has been a major improvement in the survival of patients with severe RI in the past decade, despite the increasing numbers of patients of advanced age. However, the risk of early death remains high in patients with severe RI, especially in the elderly.
BACKGROUND:Renal impairment (RI) is a common presenting complication of multiple myeloma (MM); the availability of new treatments has improved the outcomes of patients with MM; however, their impact on the survival of patients who present with RI has not been extensively studied. PATIENTS AND METHODS: We analyzed the characteristics and outcomes of 1773 consecutive unselected patients who were treated for symptomatic myeloma since January 1990. RESULTS: Although there was a significant increase in the proportion of patients of advanced age in the more recent periods, the frequency of RI as well as the proportion of patients who presented with severe RI (eGFR < 30 ml/min/1.73 m(2)) remained unchanged around 18%. Thus, after adjustment for age, there was a decrease in the risk of severe RI at presentation after 2000. Myeloma response rates (≥PR) to frontline therapy have substantially increased, and this was translated in a significant increase in the median survival. Specifically for patients with severe RI, the median OS has improved from 18 and 19.5 months in the 1990-1994 and 1995-1999 to 29 and 32 months for the periods 2000-2004 and after 2005 (P = 0.005). Severe RI was associated with a high risk of early death (12% versus 7% for patients with moderate RI versus 3% for patients with mild or no RI (P < 0.001), especially among older patients, and has remained unchanged over time. CONCLUSIONS: There has been a major improvement in the survival of patients with severe RI in the past decade, despite the increasing numbers of patients of advanced age. However, the risk of early death remains high in patients with severe RI, especially in the elderly.
Authors: Meletios A Dimopoulos; Matthew C Cheung; Murielle Roussel; Ting Liu; Barbara Gamberi; Brigitte Kolb; H Guenter Derigs; HyeonSeok Eom; Karim Belhadj; Pascal Lenain; Richard Van der Jagt; Sophie Rigaudeau; Mamoun Dib; Rachel Hall; Henry Jardel; Arnaud Jaccard; Axel Tosikyan; Lionel Karlin; William Bensinger; Rik Schots; Nicolas Leupin; Guang Chen; Jennifer Marek; Annette Ervin-Haynes; Thierry Facon Journal: Haematologica Date: 2015-12-11 Impact factor: 9.941
Authors: Abhijat Kitchlu; Eric McArthur; Eitan Amir; Christopher M Booth; Rinku Sutradhar; Habeeb Majeed; Danielle M Nash; Samuel A Silver; Amit X Garg; Christopher T Chan; S Joseph Kim; Ron Wald Journal: J Natl Cancer Inst Date: 2019-07-01 Impact factor: 13.506
Authors: Katja C Weisel; Meletios A Dimopoulos; Philippe Moreau; Martha Q Lacy; Kevin W Song; Michel Delforge; Lionel Karlin; Hartmut Goldschmidt; Anne Banos; Albert Oriol; Adrian Alegre; Christine Chen; Michele Cavo; Laurent Garderet; Valentina Ivanova; Joaquin Martinez-Lopez; Stefan Knop; Xin Yu; Kevin Hong; Lars Sternas; Christian Jacques; Mohamed H Zaki; Jesus San Miguel Journal: Haematologica Date: 2016-04-14 Impact factor: 9.941