New Myeloma-Associated Renal Impairment Recommendations

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Practical recommendations developed for diagnosis and management of renal impairment
Practical recommendations developed for diagnosis and management of renal impairment

HealthDay News — Recommendations have been developed for the diagnosis and management of multiple myeloma-related renal impairment; the guidelines were published online March 14 in the Journal of Clinical Oncology.

Meletios A. Dimopoulos, MD, from the University of Athens in Greece, and colleagues reviewed published data through December 2015 and developed practical recommendations for the diagnosis and management of multiple myeloma-related renal impairment.

The researchers recommend that all patients with myeloma should have serum creatinine, estimated glomerular filtration rate, and electrolytes measurements, as well as free light chain, if available, at diagnosis and at disease assessment; they should also have urine electrophoresis of a sample from a 24-hour urine collection (grade A). High fluid intake is indicated with antimyeloma therapy for the management of renal impairment in patients with multiple myeloma (grade B). High-cutoff hemodialysis membranes combined with antimyeloma therapy should be considered (grade B). The cornerstone for management of renal impairment remains bortezomib-based regimens (grade A). In addition, thalidomide is effective (grade B) and lenalidomide is effective and safe, mainly for patients with mild to moderate renal impairment (grade B).

"Carfilzomib can be safely administered to patients with creatinine clearance >15 mL/min, whereas ixazomib in combination with lenalidomide and dexamethasone can be safely administered to patients with creatinine clearance >30 mL/min (grade A)," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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