Observational Study: Impact of Bortezomib on Renal Function of Patients with Myeloma Nephropathy

Abstract

Introduction: The term myeloma kidney refers to the precipitation of monoclonal light chains in the renal tubules that could trigger kidney failure. The present study aims to evaluate the prognosis and survival of patients with renal failure with myeloma kidney treated with Bortezomib in an Oncology Hospital in the city of Guayaquil and to measure the association of myeloma severity with Renal involvement.

Methods: This is an observational, retrospective study of cases with a diagnosis of Multiple Myeloma (MM) that were evaluated at the National Oncological Institute "Dr. Juan Tanca Marengo ”between January 2017 to December 2017. The myeloma stage is described according to the ISS classification, glomerular filtration rate, mortality, and an association analysis is presented between myeloma staging and renal failure. An analysis of the association between MM and Nephropathy and the percentage of patients recovered with the use of Bortezomib is presented.

Results: Of 135 eligible cases, 48 cases entered the study, 13 cases (27%) with myeloma nephropathy, 21 women (44%). The average age of 56.5 ± 1.58 years. 37 cases with IgG monoclonal gammopathy (77%). 26 cases with a type of Kappa chains (54%). Relative Risk (RR) of Nephropathy for patients with stage I MM was 0.21 (95% CI 0.05-0.86) P = 0.030, in stage II: 0.22 (95% CI 0.03-1.56) P = 0.13 and in stage III: 8.97 (IC95 % 2.92-27.57) P <0.001. The overall survival was 38 months, which did not differ in the group that developed kidney disease. The total recovery of renal function after the use of Bortezomib was 50% of the cases and partial in 17%.

Conclusion: There is a positive association between myeloma stage and the presence of myeloma nephropathy. There is a very good rate of recovery of renal function in patients with myeloma nephropathy treated with Bortezomib.