Serum free light chain level at diagnosis in myeloma cast nephropathy-a multicentre study.

Blood Cancer Journal
Punit YadavPaul Cockwell

Abstract

Myeloma cast nephropathy (MCN) is a common cause of severe renal impairment in multiple myeloma (MM). The level of free light chain (FLC) that causes MCN varies substantially and there is uncertainty about the threshold level that should be used to inform clinical practice. In a multicentre cohort study of 103 patients with a diagnosis of MM and biopsy-confirmed MCN made between 2002-2014, we report prospectively measured levels of serum FLC at diagnosis obtained using a single nephelometric assay (Freelite®) and we explore the relationship between serum FLC level at diagnosis with renal outcome and patient survival. Using a landmark approach, overall survival (OS) was compared between patients who achieved independence from dialysis compared to those who remained dialysis dependent at 3-month, 6-month, 9-month, and 12-month time points. The median serum FLC level at diagnosis was 7531 mg/L (range 107-114600). Serum creatinine was 535 μmol/L (range 168-2993) and eGFR 7 ml/min/1.73 m2 (range 1-34). Six patients (5.8%) had an FLC level <1500 mg/L, which is the International Myeloma Working Group threshold for MCN and two patients were below the International Kidney and Monoclonal Gammopathy working group threshold of 500 mg/L; on...Continue Reading

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Citations

Jul 8, 2020·Cancers·Paolo MenèAntonella Stoppacciaro
Feb 2, 2021·Frontiers in Medicine·Thomas ReiterWolfgang Winnicki
Jan 14, 2021·Kidney International·Frank BridouxUNKNOWN International Kidney and Monoclonal Gammopathy Research Group
Mar 23, 2021·British Journal of Haematology·Ayumi KuzumeKosei Matsue
Apr 1, 2021·Nature Reviews. Nephrology·Frank BridouxNelson Leung
May 1, 2021·Journal of Clinical Medicine·Rupali S AvasareJonathan J Hogan
May 20, 2021·The New England Journal of Medicine·Nelson LeungSamih H Nasr

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Methods Mentioned

BETA
biopsy

Software Mentioned

SPSS®
GraphPad
Graph Pad Prism

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