Management of myeloma-associated renal dysfunction in the era of novel therapies
Open Access
- 1 February 2012
- journal article
- review article
- Published by Taylor & Francis Ltd in Expert Review of Hematology
- Vol. 5 (1), 51-68
- https://doi.org/10.1586/ehm.11.72
Abstract
Multiple myeloma (MM) is a plasma cell neoplasm often associated with renal impairment (RI), with myeloma cast nephropathy recognized as the most common cause. While RI is present in over 50% of MM patients at some point in their disease course, it is associated with higher tumor burden, more aggressive disease, diminished quality of life, development of complications and increased mortality. The introduction of novel therapies, including bortezomib, lenalidomide and thalidomide, has revolutionized the management of MM. They are now considered first-line therapies in induction, maintenance and salvage therapy for MM. In addition to their anti-MM effect, they can improve outcome in patients with RI, especially when combined, and bortezomib with dexamethasone may have a renal protective effect. This review focuses on the use of these agents in patients with MM and RI, and evaluates their efficacy, safety, need for dose adjustment and impact on RI.Keywords
This publication has 114 references indexed in Scilit:
- Improved survival in multiple myeloma and the impact of novel therapiesBlood, 2008
- Lenalidomide plus Dexamethasone for Relapsed Multiple Myeloma in North AmericaNew England Journal of Medicine, 2007
- Lenalidomide plus Dexamethasone for Relapsed or Refractory Multiple MyelomaNew England Journal of Medicine, 2007
- High serum-free light chain levels and their rapid reduction in response to therapy define an aggressive multiple myeloma subtype with poor prognosisPublished by American Society of Hematology ,2007
- Bortezomib or High-Dose Dexamethasone for Relapsed Multiple MyelomaNew England Journal of Medicine, 2005
- Immunomodulatory drug CC-5013 overcomes drug resistance and is well tolerated in patients with relapsed multiple myelomaBlood, 2002
- Antitumor Activity of Thalidomide in Refractory Multiple MyelomaNew England Journal of Medicine, 1999
- Thalidomide is an inhibitor of angiogenesis.Proceedings of the National Academy of Sciences of the United States of America, 1994
- Thalidomide exerts its inhibitory action on tumor necrosis factor alpha by enhancing mRNA degradation.The Journal of Experimental Medicine, 1993
- Manifestations of systemic light chain depositionAmerican Journal Of Medicine, 1976