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myeloma cast nephropathy

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https://www.readbyqxmd.com/read/28636627/plasma-cell-neoplasia-after-kidney-transplantation-french-cohort-series-and-review-of-the-literature
#1
Raphaël Kormann, Hélène François, Thibault Moles, Jacques Dantal, Nassim Kamar, Karine Moreau, Thomas Bachelet, Anne-Elisabeth Heng, Antoine Garstka, Charlotte Colosio, Didier Ducloux, Johnny Sayegh, Benjamin Savenkoff, Denis Viglietti, Rebecca Sberro, Eric Rondeau, Julie Peltier
Although post-transplant lymphoproliferative disorder (PTLD) is the second most common type of cancer in kidney transplantation (KT), plasma cell neoplasia (PCN) occurs only rarely after KT, and little is known about its characteristics and evolution. We included twenty-two cases of post-transplant PCN occurring between 1991 and 2013. These included 12 symptomatic multiple myeloma, eight indolent myeloma and two plasmacytomas. The median age at diagnosis was 56.5 years and the median onset after transplantation was 66...
2017: PloS One
https://www.readbyqxmd.com/read/28545410/combined-proximal-tubulopathy-crystal-storing-histiocytosis-and-cast-nephropathy-in-a-patient-with-light-chain-multiple-myeloma
#2
Chung-Kuan Wu, An-Hang Yang, Hung-Chih Lai, Bing-Shi Lin
BACKGROUND: The diagnosis of myeloma, a plasma dyscrasia, often results from the workup of unexplained renal disease. Persistent renal failure in myeloma is commonly caused by tubular nephropathy due to circulating immunoglobulins and free light chains. Myeloma cast nephropathy is characterized by crystalline precipitates of monoclonal light chains within distal tubules. Immunoglobulin crystallization rarely occurs intracellularly, within proximal tubular cells (light chain proximal tubulopathy) and interstitial histiocytes (crystal-storing histiocytosis)...
May 25, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28540855/interest-of-the-combined-measurement-of-selected-urinary-proteins-in-the-diagnosis-approach-in-nephrology
#3
Jean-Philippe Bastard, Soraya Fellahi, François-Xavier Lescure, Jacqueline Capeau, Pierre Ronco, Emmanuelle Plaisier
Determination of the protein composition of urine is a non-invasive method helping to diagnose renal lesions and evaluate therapeutic interventions. We present here five observations that highlight the performance and relevance of urine protein analysis combining selected glomerular and tubular protein measurements. Total urine protein level and measurements of urinary IgG, albumin, transferrin alpha-1 microglobulin and retinol binding protein were performed on a urine sample by immunonephelometry. The results were normalized for urine creatinine concentration and integrated in the MDI interpretation software that provides a "urine protein profile" (UPP)...
June 1, 2017: Annales de Biologie Clinique
https://www.readbyqxmd.com/read/28534173/successful-treatment-of-patients-with-newly-diagnosed-untreated-light-chain-multiple-myeloma-with-a-combination-of-bendamustine-prednisone-and-bortezomib-bpv
#4
Hannah Tessenow, Madlen Holzvogt, Bruno Holzvogt, Marc Andrea, Simone Heyn, Thomas Schliwa, Maik Schwarz, Thomas Zehrfeld, Cornelia Becker, Christian Pfrepper, Georg Nikolaus Franke, Rainer Krahl, Madlen Jentzsch, Sabine Leiblein, Sebastian Schwind, Marius Bill, Vladan Vucinic, Thoralf Lange, Dietger Niederwieser, Wolfram Pönisch
INTRODUCTION: Patients with light chain myeloma frequently have a light chain tubular cast nephropathy, which can lead to severe renal impairment. In the present retrospective study, bortezomib was combined with other active substances like bendamustine and prednisone (BPV), in order to assess the efficacy and toxicity of the combination therapy in patients with light chain multiple myeloma. METHODS: Between September 2008 and May 2015, 25 patients with newly diagnosed light chain multiple myeloma were treated with bendamustine 60 mg/m(2) on days 1 and 2, bortezomib 1...
May 22, 2017: Journal of Cancer Research and Clinical Oncology
https://www.readbyqxmd.com/read/28508985/light-chain-fanconi-syndrome-in-a-patient-with-acute-myeloid-leukemia-and-monoclonal-gammopathy-of-undetermined-significance
#5
Daniel W Ross, Rimda Wanchoo, Adriana Guigova, Cristina Ghiuzeli, Steven L Allen, Kenar D Jhaveri
Proximal tubules are a target for paraproteinemic diseases. Cast nephropathy, light chain deposition diseases, and amyloidosis are frequently encountered in patients with multiple myeloma. Rarely, a subset of patients develop light chain Fanconi syndrome (LCFS). LCFS has been reported with multiple myeloma, monoclonal gammopathy of renal significance (MGRS), chronic lymphocytic leukemia, Waldenstrom's macroglobulinemia and diffuse large B-cell lymphoma. No cases have been described with other hematologic malignancies...
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28508984/successful-treatment-of-myeloma-cast-nephropathy-using-bortezomib-based-chemotherapy-plus-selective-plasma-exchange
#6
Mayuko Kawabe, Izumi Yamamoto, Ai Katsuma, Naomi Hayashi, Yo Komatsuzaki, Yasuyuki Nakada, Akihiro Shimizu, Yudo Tanno, Ichiro Ohkido, Nobuo Tsuboi, Kazuhito Suzuki, Takaki Shimada, Yoji Ogasawara, Katsuki Sugiyama, Keisuke Aiba, Takashi Yokoo
Myeloma cast nephropathy is a major complication of multiple myeloma. Recent evidence has demonstrated that the earlier induction of bortezomib-based chemotherapy with plasma exchange (PE) provides better results for kidney function and patient survival. Due to its non-selectivity, PE with albumin replacement carries the risk of fibrinogen loss, leading to bleeding. We herein report a case of successful treatment of myeloma cast nephropathy using bortezomib-based chemotherapy and selective PE. A 61-year-old woman who had a 20-year history of type II diabetes mellitus was admitted to our hospital for the evaluation of hypercalcemia, severe kidney dysfunction, and anemia...
November 2016: CEN Case Reports
https://www.readbyqxmd.com/read/28495862/the-diagnosis-wide-landscape-of-hospital-acquired-aki
#7
Anne-Sophie Jannot, Anita Burgun, Eric Thervet, Nicolas Pallet
BACKGROUND AND OBJECTIVES: The exploration of electronic hospital records offers a unique opportunity to describe in-depth the prevalence of conditions associated with diagnoses at an unprecedented level of comprehensiveness. We used a diagnosis-wide approach, adapted from phenome-wide association studies (PheWAS), to perform an exhaustive analysis of all diagnoses associated with hospital-acquired AKI (HA-AKI) in a French urban tertiary academic hospital over a period of 10 years. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We retrospectively extracted all diagnoses from an i2b2 (Informatics for Integrating Biology and the Bedside) clinical data warehouse for patients who stayed in this hospital between 2006 and 2015 and had at least two plasma creatinine measurements performed during the first week of their stay...
June 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28457684/-classification-and-therapeutic-management-of-monoclonal-gammopathies-of-renal-significance
#8
V Javaugue, I Bouteau, C Sirac, N Quellard, J Diolez, A Colombo, E Desport, L Ecotière, J-M Goujon, J-P Fermand, G Touchard, A Jaccard, F Bridoux
Two categories of renal disorders associated with monoclonal gammopathies are to be distinguished, according to the characteristics of the underlying B-cell clone. The first group of renal diseases always occurs in the setting of high tumor mass with production of large amounts of monoclonal immunoglobulins. The main complication is the so-called myeloma cast nephropathy, which almost invariably complicates high tumor mass myeloma. The second group includes all renal disorders caused by a monoclonal immunoglobulin secreted by a nonmalignant B-cell clone, and currently referred as a "monoclonal gammopathy of renal significance (MGRS)"...
April 27, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28446322/-research-advances-in-treatment-of-myeloma-nephropathy-review
#9
Xiao-Ping Zhang, Zu-Yao Xia, Bao-An Chen, Chong Gao
Myeloma nephropathy is a common complication in patients with myltiple myeloma (MM) that causes high morbidity. In the majority of cases, renal impairment is caused by the accumulation and precipitation of light chains, which form casts in the distal tubules, resulting in renal obstruction. This review discusses the recent advances on its treatment, so as to provide reference for clinical treatment of MM induced-renal failure.
April 2017: Zhongguo Shi Yan Xue Ye Xue za Zhi
https://www.readbyqxmd.com/read/28383130/clinical-characteristics-and-prognostic-factors-in-multiple-myeloma-patients-with-light-chain-deposition-disease
#10
Meera Mohan, Amy Buros, Pankaj Mathur, Neriman Gokden, Manisha Singh, Sandra Susanibar, Jorge Jo Kamimoto, Shadiqul Hoque, Muthukumar Radhakrishnan, Aasiya Matin, Cynthia Davis, Monica Grazziutti, Sharmilan Thanendrarajan, Frits van Rhee, Maurizio Zangari, Faith Davies, Gareth Morgan, Joshua Epstein, Bart Barlogie, Carolina Schinke
Light chain deposition disease (LCDD) is characterized by monotypic immunoglobulin depositions which will eventually lead to loss of organ function if left untreated. While the kidney is almost always affected, the presence and degree of LCDD in other organs vary. Ten to 30% of LCDD patients have underlying Multiple Myeloma (MM), yet outcome and prognostic markers in this particular patient group are still lacking. Here, we analyzed 69 patients with MM and biopsy proven LCDD and report on renal and extra-renal involvement and its impact on prognosis as well as renal response depending on hematologic response...
April 6, 2017: American Journal of Hematology
https://www.readbyqxmd.com/read/27988790/pharmacokinetics-of-lenalidomide-during-high-cut-off-dialysis-in-a-patient-with-multiple-myeloma-and-renal-failure
#11
Kim Dao, Yimin Lu, Cody J Peer, William D Figg, Raphael Stadelmann, Michel Burnier, Thierry Buclin, Sebastien Kissling
INTRODUCTION: High cut-off dialysis, increasingly used in multiple myeloma patients, is susceptible to influence anticancer drug elimination. We report about lenalidomide disposition in a patient on high cut-off dialysis for renal failure secondary to myeloma cast nephropathy. METHODS: The patient received a higher dosage of lenalidomide (5 mg b.i.d.), owing to concerns about a potential decrease in lenalidomide exposure during dialysis sessions. A set of blood samples was taken in order to develop a pharmacokinetic model accounting for lenalidomide concentrations in this setting...
January 2017: Cancer Chemotherapy and Pharmacology
https://www.readbyqxmd.com/read/27757797/light-chains-removal-by-extracorporeal-techniques-in-acute-kidney-injury-due-to-multiple-myeloma-a-position-statement-of-the-onconephrology-work-group-of-the-italian-society-of-nephrology
#12
P Fabbrini, K Finkel, M Gallieni, G Capasso, M Cavo, A Santoro, S Pasquali
Acute kidney injury (AKI) is a frequent complication of multiple myeloma and is associated with increased short-term mortality. Additionally, even a single episode of AKI can eventually lead to end-stage renal disease (ESRD), significantly reducing quality of life and long-term survival. In the setting of multiple myeloma, severe AKI (requiring dialysis) is typically secondary to cast nephropathy (CN). Renal injury in CN is due to intratubular obstruction from precipitation of monoclonal serum free light chains (sFLC) as well as direct tubular toxicity of sFLC via stimulation of nuclear factor (NF)κB inflammatory pathways...
December 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27646819/current-treatments-for-renal-failure-due-to-multiple-myeloma
#13
REVIEW
Maria Gavriatopoulou, Evangelos Terpos, Efstathios Kastritis, Meletios A Dimopoulos
Renal impairment (RI) is one of the most common complication of multiple myeloma (MM). RI is present in almost 20% of MM patients at diagnosis and in 40%-50% of patients during the course of their disease. Areas covered: Biology along with tools for diagnosis and management of RI are reported in this paper. Papers published in PubMed and reported abstracts up to May 2016 were used. Expert opinion: Moderate and severe RI increases the risk of early death; thus rapid intervention and initiation of anti-myeloma treatment is essential and improves renal outcomes in RI patients...
November 2016: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27536684/current-trends-of-renal-impairment-in-multiple-myeloma
#14
REVIEW
Punit Yadav, Mark Cook, Paul Cockwell
BACKGROUND: Renal impairment (RI) is a common complication of multiple myeloma (MM). Around 50% of patients with MM have RI at presentation, and up to 5% require dialysis treatment. Severe acute kidney injury (AKI) as a cause of RI is a particular challenge as historically the survival of patients who sustain this complication and require dialysis is very poor. However, in this current period, survival is improving and the focus is on optimum use of novel chemotherapies and the evaluation of extra-corporeal therapies for removal of serum immunoglobulin light chains...
March 2016: Kidney Diseases
https://www.readbyqxmd.com/read/27526708/paraprotein-related-kidney-disease-evaluation-and-treatment-of-myeloma-cast-nephropathy
#15
Kevin W Finkel, Eric P Cohen, Anushree Shirali, Ala Abudayyeh
Nearly 50% of patients with multiple myeloma develop renal disease, most commonly from AKI caused by cast nephropathy. Development of AKI is associated with poor 1-year survival and reduces the therapeutic options available to patients. There is a great need for more effective therapies. Cast nephropathy is caused by the interaction and aggregation of filtered free light chains and Tamm-Horsfall protein causing intratubular obstruction and damage. The key to treating cast nephropathy is rapid lowering of free light chains, because this correlates with renal recovery...
December 7, 2016: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27504298/non-secretory-myeloma-diagnosed-on-renal-biopsy-as-cast-nephropathy
#16
Sumit Grover, Pavneet Kaur Selhi, Neena Sood, Jasvinder Singh Sandhu, Harpreet Kaur
Multiple myeloma is a disorder of plasma cells which can involve kidneys in the form of cast nephropathy. Neoplastic plasma cells produce either complete immunoglobulins or fragments of immunoglobulins leading to a monoclonal spike in the serum and/or Bence Jones proteinuria. Very few patients present as non-secretory myeloma when no immunoglobulins (M spike) are produced or only light chains are secreted which can only be detected in urine. Acute renal failure due to cast nephropathy can rarely be the first presentation of multiple myeloma...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27467401/therapeutic-efficacy-and-cost-effectiveness-of-high-cut-off-dialyzers-compared-to-conventional-dialysis-in-patients-with-cast-nephropathy
#17
Adriano Curti, Albin Schwarz, Johannes Trachsler, Yuki Tomonaga, Patrice M Ambühl
BACKGROUND: High Cut-Off (HCO) dialysis membranes efficiently reduce serum free light chain (FLC) concentrations and may improve renal recovery and survival from multiple myeloma (MM) associated renal failure with cast nephropathy. However, clinical trials comparing dialysis with HCO versus conventional filters are lacking. The aim of this study was to assess clinical outcomes and economic impact of HCO dialyzers compared to conventional hemodialysis membranes in cast nephropathy. METHODS: Multicenter retrospective analysis of 19 patients treated for renal failure from FLC associated cast nephropathy with standard induction chemotherapy (bortezomib/dexamethasone)...
2016: PloS One
https://www.readbyqxmd.com/read/27437235/unusual-presentation-of-light-chain-deposition-disease-a-case-report
#18
Disha Arora, Mayank Uppal, Vindu Amitabh, Usha Agrawal
Light Chain Deposition Disease (LCDD) is a rare disease characterized by deposition of monoclonal non-amyloid light chains in multiple organs. We report an unusual histologic manifestation of LCDD in a 55-year-old female patient, who presented with nephrotic syndrome and an increased serum creatinine. This case of LCDD had features of cast nephropathy on biopsy which is diagnostic of myeloma kidney, when the patient was clinically asymptomatic. Serum electrophoresis showed no abnormal band. There was no other evidence of a B-cell clonal disorder or amyloidosis...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27270690/effective-removal-of-%C3%AE%C2%BA-free-light-chains-with-hemodialysis-using-fresenius-ultraflux%C3%A2-emic%C3%A2-2-dialyser-in-a-patient-with-myeloma-cast-nephropathy-with-associated-cost-savings
#19
LETTER
Mathini Jayaballa, Bhadran Bose, Muralikrishna Gangadharan Komala, Eddy Ronald Fischer, John Taper, Kamal Sud
No abstract text is available yet for this article.
2016: Blood Purification
https://www.readbyqxmd.com/read/27255910/thirteen-treated-of-acute-renal-failure-secondary-to-multiple-myeloma-with-high-cut-off-filters
#20
Ana Berni Wennekers, María Pilar Martín Azara, Victoria Dourdil Sahun, Beatriz Bergasa Liberal, José Esteban Ruiz Laiglesia, Patricia Vernet Perna, Rafael Alvarez Lipe
INTRODUCTION: Multiple myeloma (MM) is a haematological tumour that is characterised by uncontrolled proliferation of plasma cells and a significant volume of serum free light chains (sFLCs), which can cause acute renal failure due to intratubular precipitation, resulting in cast nephropathy. Acute renal failure is a complication that can arise in more than 20% of patients with multiple myeloma, half of which will require dialysis. METHODS: We report our experience with 13 patients who were treated with dialysis using high cut off filters (HCO) between July 2011 and February 2015...
July 2016: Nefrología: Publicación Oficial de la Sociedad Española Nefrologia
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