Clinical and prognostic differences among patients with light chain deposition disease, myeloma cast nephropathy and both

Ladan Zand; Samih H. Nasr; Morie A. Gertz; Angela Dispenzieri; Martha Q. Lacy; Francis K. Buadi; Shaji Kumar; Robert A. Kyle; Fernando C. Fervenza; Sanjeev Sethi; David Dingli; S. Vincent Rajkumar; Prashant Kapoor; Arleigh McCurdy; Nelson Leung

doi:10.3109/10428194.2015.1040011

Clinical and prognostic differences among patients with light chain deposition disease, myeloma cast nephropathy and both

Ladan Zand, Samih H. Nasr, Morie A. Gertz, Angela Dispenzieri, Martha Q. Lacy, Francis K. Buadi, Shaji Kumar, Robert A. Kyle, Fernando C. Fervenza, Sanjeev Sethi, David Dingli, S. Vincent Rajkumar, Prashant Kapoor, Arleigh McCurdy, Nelson Leung

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Abstract

In some patients with light chain deposition disease (LCDD) there is also evidence of myeloma cast nephropathy (MCN) on renal biopsy. The purpose of this study was to evaluate the renal and survival outcome of patients with concomitant diagnosis of MCN and LCDD to LCDD and MCN alone. Eighty seven patients were identified and divided into LCDD (n = 45), MCN (n = 29), and LCDD+ MCN (n = 13). Patients with LCDD+ MCN had a worse overall survival (OS) compared to patients with LCDD (p = 0.03), but similar to patients with MCN (p = 0.4). Death-censored renal survival was no different amongst the groups. Presenting with acute renal failure at time of renal biopsy (HR 7.2, p = 0.0002) was an independent poor renal prognostic factor while older age (HR 1.06, p = 0.0002), presence of osteolytic lesions (HR 4.4, p < 0.0001), and requirement for dialysis or creatinine ≥ 5 mg/dL (HR 3.2, p = 0.0006) at time of renal biopsy were independent poor prognostic factors for OS.

Original language	English (US)
Pages (from-to)	3357-3364
Number of pages	8
Journal	Leukemia and Lymphoma
Volume	56
Issue number	12
DOIs	https://doi.org/10.3109/10428194.2015.1040011
State	Published - Dec 2 2015
Externally published	Yes

Bibliographical note

Publisher Copyright:
© 2015 Informa UK, Ltd.

Keywords

Light chain deposition disease
multiple myeloma
myeloma cast nephropathy
renal disease

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.3109/10428194.2015.1040011

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Zand, L., Nasr, S. H., Gertz, M. A., Dispenzieri, A., Lacy, M. Q., Buadi, F. K., Kumar, S., Kyle, R. A., Fervenza, F. C., Sethi, S., Dingli, D., Rajkumar, S. V., Kapoor, P., McCurdy, A., & Leung, N. (2015). Clinical and prognostic differences among patients with light chain deposition disease, myeloma cast nephropathy and both. Leukemia and Lymphoma, 56(12), 3357-3364. https://doi.org/10.3109/10428194.2015.1040011

Zand, L, Nasr, SH, Gertz, MA, Dispenzieri, A, Lacy, MQ, Buadi, FK, Kumar, S, Kyle, RA, Fervenza, FC, Sethi, S, Dingli, D, Rajkumar, SV, Kapoor, P, McCurdy, A & Leung, N 2015, 'Clinical and prognostic differences among patients with light chain deposition disease, myeloma cast nephropathy and both', Leukemia and Lymphoma, vol. 56, no. 12, pp. 3357-3364. https://doi.org/10.3109/10428194.2015.1040011

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abstract = "In some patients with light chain deposition disease (LCDD) there is also evidence of myeloma cast nephropathy (MCN) on renal biopsy. The purpose of this study was to evaluate the renal and survival outcome of patients with concomitant diagnosis of MCN and LCDD to LCDD and MCN alone. Eighty seven patients were identified and divided into LCDD (n = 45), MCN (n = 29), and LCDD+ MCN (n = 13). Patients with LCDD+ MCN had a worse overall survival (OS) compared to patients with LCDD (p = 0.03), but similar to patients with MCN (p = 0.4). Death-censored renal survival was no different amongst the groups. Presenting with acute renal failure at time of renal biopsy (HR 7.2, p = 0.0002) was an independent poor renal prognostic factor while older age (HR 1.06, p = 0.0002), presence of osteolytic lesions (HR 4.4, p < 0.0001), and requirement for dialysis or creatinine ≥ 5 mg/dL (HR 3.2, p = 0.0006) at time of renal biopsy were independent poor prognostic factors for OS.",

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AU - Zand, Ladan

AU - Nasr, Samih H.

AU - Gertz, Morie A.

AU - Dispenzieri, Angela

AU - Lacy, Martha Q.

AU - Buadi, Francis K.

AU - Kumar, Shaji

AU - Kyle, Robert A.

AU - Fervenza, Fernando C.

AU - Sethi, Sanjeev

AU - Dingli, David

AU - Rajkumar, S. Vincent

AU - Kapoor, Prashant

AU - McCurdy, Arleigh

AU - Leung, Nelson

PY - 2015/12/2

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N2 - In some patients with light chain deposition disease (LCDD) there is also evidence of myeloma cast nephropathy (MCN) on renal biopsy. The purpose of this study was to evaluate the renal and survival outcome of patients with concomitant diagnosis of MCN and LCDD to LCDD and MCN alone. Eighty seven patients were identified and divided into LCDD (n = 45), MCN (n = 29), and LCDD+ MCN (n = 13). Patients with LCDD+ MCN had a worse overall survival (OS) compared to patients with LCDD (p = 0.03), but similar to patients with MCN (p = 0.4). Death-censored renal survival was no different amongst the groups. Presenting with acute renal failure at time of renal biopsy (HR 7.2, p = 0.0002) was an independent poor renal prognostic factor while older age (HR 1.06, p = 0.0002), presence of osteolytic lesions (HR 4.4, p < 0.0001), and requirement for dialysis or creatinine ≥ 5 mg/dL (HR 3.2, p = 0.0006) at time of renal biopsy were independent poor prognostic factors for OS.

AB - In some patients with light chain deposition disease (LCDD) there is also evidence of myeloma cast nephropathy (MCN) on renal biopsy. The purpose of this study was to evaluate the renal and survival outcome of patients with concomitant diagnosis of MCN and LCDD to LCDD and MCN alone. Eighty seven patients were identified and divided into LCDD (n = 45), MCN (n = 29), and LCDD+ MCN (n = 13). Patients with LCDD+ MCN had a worse overall survival (OS) compared to patients with LCDD (p = 0.03), but similar to patients with MCN (p = 0.4). Death-censored renal survival was no different amongst the groups. Presenting with acute renal failure at time of renal biopsy (HR 7.2, p = 0.0002) was an independent poor renal prognostic factor while older age (HR 1.06, p = 0.0002), presence of osteolytic lesions (HR 4.4, p < 0.0001), and requirement for dialysis or creatinine ≥ 5 mg/dL (HR 3.2, p = 0.0006) at time of renal biopsy were independent poor prognostic factors for OS.

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KW - multiple myeloma

KW - myeloma cast nephropathy

KW - renal disease

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Clinical and prognostic differences among patients with light chain deposition disease, myeloma cast nephropathy and both

Abstract

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Keywords

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