Abstract
Background: Renal impairment (RI) is a common complication of multiple myeloma (MM) and remains a poor prognostic factor despite improved survival with newer therapies. Patients and Methods: We evaluated baseline characteristics, treatment, and outcomes of newly diagnosed MM patients with RI at diagnosis in the Australia and New Zealand Myeloma and Related Diseases Registry over 5 years to April 2018; we compared patients with RI (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2) with those with eGFR ≥60. In autologous stem cell transplantation (ASCT) analyses, patients aged 70 years and younger and ≥1 year from diagnosis were included. Results: Overall, 36% of patients with newly diagnosed MM had RI; they were older, had more advanced disease and comorbidities, and worse performance status. Bortezomib-based induction therapy was most commonly used, although administered to fewer RI patients, despite similar response rates. Patients with RI were less likely to receive ASCT; however, recipients had longer progression-free survival (PFS) and overall survival (OS). Patients with RI had shorter OS and PFS after adjusting for age. In ASCT recipients with RI versus no RI, there was no difference in PFS and OS. Conclusion: Our findings in “real world” MM patients with RI confirm that patient-, disease-, and treatment-related factors (such as suboptimal bortezomib and ASCT use), and delays in commencing therapy, might contribute to poorer outcomes, and support the use of ASCT in patients with RI.
| Original language | English |
|---|---|
| Number of pages | 10 |
| Journal | Clinical Lymphoma, Myeloma and Leukemia |
| DOIs | |
| Publication status | Accepted/In press - 16 May 2019 |
Keywords
- Autologous
- Multiple myeloma
- Registry
- Renal Impairment
- Transplantation
Cite this
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Renal impairment at diagnosis in myeloma : Patient characteristics, treatment, and impact on outcomes. Results from the Australia and New Zealand Myeloma and Related Diseases Registry. / Ho, P. Joy; Moore, Elizabeth M.; McQuilten, Zoe K.; Wellard, Cameron; Bergin, Krystal; Augustson, Bradley; Blacklock, Hilary; Harrison, Simon J.; Horvath, Noemi; King, Tracy; Mollee, Peter; Quach, Hang; Reid, Christopher; Rosengarten, Brian; Walker, Patricia; Wood, Erica M.; Spencer, Andrew.
In: Clinical Lymphoma, Myeloma and Leukemia, 16.05.2019.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Renal impairment at diagnosis in myeloma
T2 - Patient characteristics, treatment, and impact on outcomes. Results from the Australia and New Zealand Myeloma and Related Diseases Registry
AU - Ho, P. Joy
AU - Moore, Elizabeth M.
AU - McQuilten, Zoe K.
AU - Wellard, Cameron
AU - Bergin, Krystal
AU - Augustson, Bradley
AU - Blacklock, Hilary
AU - Harrison, Simon J.
AU - Horvath, Noemi
AU - King, Tracy
AU - Mollee, Peter
AU - Quach, Hang
AU - Reid, Christopher
AU - Rosengarten, Brian
AU - Walker, Patricia
AU - Wood, Erica M.
AU - Spencer, Andrew
PY - 2019/5/16
Y1 - 2019/5/16
N2 - Background: Renal impairment (RI) is a common complication of multiple myeloma (MM) and remains a poor prognostic factor despite improved survival with newer therapies. Patients and Methods: We evaluated baseline characteristics, treatment, and outcomes of newly diagnosed MM patients with RI at diagnosis in the Australia and New Zealand Myeloma and Related Diseases Registry over 5 years to April 2018; we compared patients with RI (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2) with those with eGFR ≥60. In autologous stem cell transplantation (ASCT) analyses, patients aged 70 years and younger and ≥1 year from diagnosis were included. Results: Overall, 36% of patients with newly diagnosed MM had RI; they were older, had more advanced disease and comorbidities, and worse performance status. Bortezomib-based induction therapy was most commonly used, although administered to fewer RI patients, despite similar response rates. Patients with RI were less likely to receive ASCT; however, recipients had longer progression-free survival (PFS) and overall survival (OS). Patients with RI had shorter OS and PFS after adjusting for age. In ASCT recipients with RI versus no RI, there was no difference in PFS and OS. Conclusion: Our findings in “real world” MM patients with RI confirm that patient-, disease-, and treatment-related factors (such as suboptimal bortezomib and ASCT use), and delays in commencing therapy, might contribute to poorer outcomes, and support the use of ASCT in patients with RI.
AB - Background: Renal impairment (RI) is a common complication of multiple myeloma (MM) and remains a poor prognostic factor despite improved survival with newer therapies. Patients and Methods: We evaluated baseline characteristics, treatment, and outcomes of newly diagnosed MM patients with RI at diagnosis in the Australia and New Zealand Myeloma and Related Diseases Registry over 5 years to April 2018; we compared patients with RI (estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m2) with those with eGFR ≥60. In autologous stem cell transplantation (ASCT) analyses, patients aged 70 years and younger and ≥1 year from diagnosis were included. Results: Overall, 36% of patients with newly diagnosed MM had RI; they were older, had more advanced disease and comorbidities, and worse performance status. Bortezomib-based induction therapy was most commonly used, although administered to fewer RI patients, despite similar response rates. Patients with RI were less likely to receive ASCT; however, recipients had longer progression-free survival (PFS) and overall survival (OS). Patients with RI had shorter OS and PFS after adjusting for age. In ASCT recipients with RI versus no RI, there was no difference in PFS and OS. Conclusion: Our findings in “real world” MM patients with RI confirm that patient-, disease-, and treatment-related factors (such as suboptimal bortezomib and ASCT use), and delays in commencing therapy, might contribute to poorer outcomes, and support the use of ASCT in patients with RI.
KW - Autologous
KW - Multiple myeloma
KW - Registry
KW - Renal Impairment
KW - Transplantation
UR - http://www.scopus.com/inward/record.url?scp=85067210337&partnerID=8YFLogxK
U2 - 10.1016/j.clml.2019.05.010
DO - 10.1016/j.clml.2019.05.010
M3 - Article
JO - Clinical Lymphoma, Myeloma & Leukemia
JF - Clinical Lymphoma, Myeloma & Leukemia
SN - 2152-2650
ER -