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 |
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| Authors: | P Joy Ho Elizabeth M Moore Zoe K McQuilten Cameron Wellard Krystal Bergin Bradley Augustson Hilary Blacklock Simon J Harrison Noemi Horvath Tracy King Peter Mollee Hang Quach Christopher Reid Brian Rosengarten Patricia Walker Erica M Wood Andrew Spencer |
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| Institution: | 1. Institute of Haematology, Royal Prince Alfred Hospital, Missenden Road, Camperdown, New South Wales, and University of Sydney, Sydney, Australia;2. School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia;3. Department of Haematology, Alfred Health-Monash University, Melbourne, Victoria, Australia;4. Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia;5. Middlemore Hospital, Middlemore, Auckland, New Zealand;6. Clinical Haematology, Peter MacCallum Cancer Centre and Royal Melbourne Hospital, Melbourne, Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Melbourne, Australia;7. Royal Adelaide Hospital, Adelaide, South Australia, Australia;8. Sydney Nursing School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia;9. Haematology Department, Princess Alexandra Hospital, Woolloongabba, Queensland, School of Medicine, University of Queensland, Brisbane, Australia;10. University of Melbourne, St Vincent’s Hospital, Victoria, Australia;11. Myeloma Australia, Richmond, Victoria, Australia |
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| Abstract: | BackgroundRenal impairment (RI) is a common complication of multiple myeloma (MM) and remains a poor prognostic factor despite improved survival with newer therapies.Patients and MethodsWe 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.ResultsOverall, 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.ConclusionOur 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. |
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| Keywords: | Address for correspondence: P Joy Ho MBBS Institute of Haematology Royal Prince Alfred Hospital Missenden Rd Camperdown NSW 2050 Australia Autologous Multiple myeloma Registry Renal Impairment Transplantation |
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