Cancers (Mar 2021)
Kinetics of Renal Function during Induction in Newly Diagnosed Multiple Myeloma: Results of Two Prospective Studies by the German Myeloma Study Group DSMM
- Friederike Bachmann,
- Martin Schreder,
- Monika Engelhardt,
- Christian Langer,
- Denise Wolleschak,
- Lars Olof Mügge,
- Heinz Dürk,
- Kerstin Schäfer-Eckart,
- Igor Wolfgang Blau,
- Martin Gramatzki,
- Peter Liebisch,
- Matthias Grube,
- Ivana v Metzler,
- Florian Bassermann,
- Bernd Metzner,
- Christoph Röllig,
- Bernd Hertenstein,
- Cyrus Khandanpour,
- Tobias Dechow,
- Holger Hebart,
- Wolfram Jung,
- Sebastian Theurich,
- Georg Maschmeyer,
- Hans Salwender,
- Georg Hess,
- Max Bittrich,
- Leo Rasche,
- Annamaria Brioli,
- Kai-Uwe Eckardt,
- Christian Straka,
- Swantje Held,
- Hermann Einsele,
- Stefan Knop
Affiliations
- Friederike Bachmann
- Division of Nephrology and Medical Intensive Care, Charité University Medicine, 10117 Berlin, Germany
- Martin Schreder
- Division of Hematology and Oncology, Würzburg University Hospital Medical Center, 97080 Würzburg, Germany
- Monika Engelhardt
- Freiburg University Hospital, 79106 Freiburg, Germany
- Christian Langer
- Ulm University Hospital, 89070 Ulm, Germany
- Denise Wolleschak
- Magdeburg University Hospital, 39120 Magdeburg, Germany
- Lars Olof Mügge
- Jena University Hospital, 07747 Jena, Germany
- Heinz Dürk
- St. Barbara- Hospital Hamm GmbH, 59075 Hamm, Germany
- Kerstin Schäfer-Eckart
- Nuremberg Hospital, Paracelsus Medizinische Privatuniversität, 90419 Nuremberg, Germany
- Igor Wolfgang Blau
- Division of Hematology and Immunology, Charité University Medicine, 13353 Berlin, Germany
- Martin Gramatzki
- Schleswig-Holstein University Hospital, Kiel Campus, 24105 Kiel, Germany
- Peter Liebisch
- Private Oncology Practice, 47441 Moers, Germany
- Matthias Grube
- Regensburg University Hospital, 93043 Regensburg, Germany
- Ivana v Metzler
- Frankfurt University Hospital, 60590 Frankfurt, Germany
- Florian Bassermann
- University Hospital re. d. Isar, 81675 Munich, Germany
- Bernd Metzner
- Oldenburg University Hospital, 26133 Oldenburg, Germany
- Christoph Röllig
- Dresden Carl Gustav Carus University Hospital, 01307 Dresden, Germany
- Bernd Hertenstein
- Bremen Municipal Hospital Mitte, 28205 Bremen, Germany
- Cyrus Khandanpour
- Munster University Hospital, 48149 Munster, Germany
- Tobias Dechow
- Private Oncology Practice, 88212 Ravensburg, Germany
- Holger Hebart
- Stauferklinikum, Schwäbisch Gmünd, 73557 Mutlangen, Germany
- Wolfram Jung
- Göttingen University Hospital, 37099 Göttingen, Germany
- Sebastian Theurich
- Munich Großhadern University Hospital, 80336 Munich, Germany
- Georg Maschmeyer
- Ernst von Bergmann Hospital, 14467 Potsdam, Germany
- Hans Salwender
- Asklepios Klinikum Altona, 22763 Hamburg, Germany
- Georg Hess
- Mainz University Hospital, 55131 Mainz, Germany
- Max Bittrich
- Division of Hematology and Oncology, Würzburg University Hospital Medical Center, 97080 Würzburg, Germany
- Leo Rasche
- Division of Hematology and Oncology, Würzburg University Hospital Medical Center, 97080 Würzburg, Germany
- Annamaria Brioli
- Jena University Hospital, 07747 Jena, Germany
- Kai-Uwe Eckardt
- Division of Nephrology and Medical Intensive Care, Charité University Medicine, 10117 Berlin, Germany
- Christian Straka
- Munich Hospital Schwabing, 80804 Munich, Germany
- Swantje Held
- Department of Biostatistics at ClinAssess GmbH, 51379 Leverkusen, Germany
- Hermann Einsele
- Division of Hematology and Oncology, Würzburg University Hospital Medical Center, 97080 Würzburg, Germany
- Stefan Knop
- Division of Hematology and Oncology, Würzburg University Hospital Medical Center, 97080 Würzburg, Germany
- DOI
- https://doi.org/10.3390/cancers13061322
- Journal volume & issue
-
Vol. 13,
no. 6
p. 1322
Abstract
Background: Preservation of kidney function in newly diagnosed (ND) multiple myeloma (MM) helps to prevent excess toxicity. Patients (pts) from two prospective trials were analyzed, provided postinduction (PInd) restaging was performed. Pts received three cycles with bortezomib (btz), cyclophosphamide, and dexamethasone (dex; VCD) or btz, lenalidomide (len), and dex (VRd) or len, adriamycin, and dex (RAD). The minimum required estimated glomerular filtration rate (eGFR) was >30 mL/min. We analyzed the percent change of the renal function using the International Myeloma Working Group (IMWG) criteria and Kidney Disease: Improving Global Outcomes (KDIGO)-defined categories. Results: Seven hundred and seventy-two patients were eligible. Three hundred and fifty-six received VCD, 214 VRd, and 202 RAD. VCD patients had the best baseline eGFR. The proportion of pts with eGFR p p = 0.0872). IMWG-defined “renal complete response (CRrenal)” was achieved in 17/25 (68%) pts after VCD, 12/19 (63%) after RAD, and 14/27 (52%) after VRd (p = 0.4747). Conclusions: Analyzing a large and representative newly diagnosed myeloma (NDMM) group, we found no difference in CRrenal that occurred independently from the myeloma response across the three regimens. A trend towards deterioration of the renal function with VRd versus VCD may be explained by a better pretreatment “renal fitness” in the latter group.
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