Multiple myeloma with acute light chain cast nephropathy
Abstract Light chain cast nephropathy (LCCN) is a leading cause of acute kidney injury (AKI) in patients with multiple myeloma (MM) and is now defined as a myeloma defining event. While the long-term prognosis has improved with novel agents, short-term mortality remains significantly higher in patie...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Publishing Group
2023-03-01
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| Series: | Blood Cancer Journal |
| Online Access: | https://doi.org/10.1038/s41408-023-00806-w |
| _version_ | 1797854024867774464 |
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| author | Nelson Leung S. Vincent Rajkumar |
| author_facet | Nelson Leung S. Vincent Rajkumar |
| author_sort | Nelson Leung |
| collection | DOAJ |
| description | Abstract Light chain cast nephropathy (LCCN) is a leading cause of acute kidney injury (AKI) in patients with multiple myeloma (MM) and is now defined as a myeloma defining event. While the long-term prognosis has improved with novel agents, short-term mortality remains significantly higher in patients with LCCN especially if the renal failure is not reversed. Recovery of renal function requires a rapid and significant reduction of the involved serum free light chain. Therefore, proper treatment of these patients is of the utmost importance. In this paper, we provide an algorithm for treatment of MM patients who present with biopsy-proven LCCN or in those where other causes of AKI have been ruled out. The algorithm is based on data from randomized trial whenever possible. When trial data is not available, our recommendations is based on non-randomized data and expert opinions on best practices. We recommend that all patients should enroll in a clinical trial if available prior to resorting to the treatment algorithm we outlined. |
| first_indexed | 2024-04-09T20:00:20Z |
| format | Article |
| id | doaj.art-f025813352404bd1a1e219dfe1f26f3b |
| institution | Directory Open Access Journal |
| issn | 2044-5385 |
| language | English |
| last_indexed | 2024-04-09T20:00:20Z |
| publishDate | 2023-03-01 |
| publisher | Nature Publishing Group |
| record_format | Article |
| series | Blood Cancer Journal |
| spelling | doaj.art-f025813352404bd1a1e219dfe1f26f3b2023-04-03T05:17:14ZengNature Publishing GroupBlood Cancer Journal2044-53852023-03-011311710.1038/s41408-023-00806-wMultiple myeloma with acute light chain cast nephropathyNelson Leung0S. Vincent Rajkumar1Division of Hematology, Mayo ClinicDivision of Hematology, Mayo ClinicAbstract Light chain cast nephropathy (LCCN) is a leading cause of acute kidney injury (AKI) in patients with multiple myeloma (MM) and is now defined as a myeloma defining event. While the long-term prognosis has improved with novel agents, short-term mortality remains significantly higher in patients with LCCN especially if the renal failure is not reversed. Recovery of renal function requires a rapid and significant reduction of the involved serum free light chain. Therefore, proper treatment of these patients is of the utmost importance. In this paper, we provide an algorithm for treatment of MM patients who present with biopsy-proven LCCN or in those where other causes of AKI have been ruled out. The algorithm is based on data from randomized trial whenever possible. When trial data is not available, our recommendations is based on non-randomized data and expert opinions on best practices. We recommend that all patients should enroll in a clinical trial if available prior to resorting to the treatment algorithm we outlined.https://doi.org/10.1038/s41408-023-00806-w |
| spellingShingle | Nelson Leung S. Vincent Rajkumar Multiple myeloma with acute light chain cast nephropathy Blood Cancer Journal |
| title | Multiple myeloma with acute light chain cast nephropathy |
| title_full | Multiple myeloma with acute light chain cast nephropathy |
| title_fullStr | Multiple myeloma with acute light chain cast nephropathy |
| title_full_unstemmed | Multiple myeloma with acute light chain cast nephropathy |
| title_short | Multiple myeloma with acute light chain cast nephropathy |
| title_sort | multiple myeloma with acute light chain cast nephropathy |
| url | https://doi.org/10.1038/s41408-023-00806-w |
| work_keys_str_mv | AT nelsonleung multiplemyelomawithacutelightchaincastnephropathy AT svincentrajkumar multiplemyelomawithacutelightchaincastnephropathy |