TY - JOUR
T1 - International myeloma working group recommendations for the diagnosis and management of myeloma-related renal impairment
AU - International Myeloma Working Group
AU - Dimopoulos, Meletios A.
AU - Sonneveld, Pieter
AU - Leung, Nelson
AU - Merlini, Giampaolo
AU - Ludwig, Heinz
AU - Kastritis, Efstathios
AU - Goldschmidt, Hartmut
AU - Joshua, Douglas
AU - Orlowski, Robert Z.
AU - Powles, Raymond
AU - Vesole, David H.
AU - Garderet, Laurent
AU - Einsele, Hermann
AU - Palumbo, Antonio
AU - Cavo, Michele
AU - Richardson, Paul G.
AU - Moreau, Philippe
AU - Miguel, Jesús San
AU - Vincent Rajkumar, S.
AU - Durie, Brian G.M.
AU - Terpos, Evangelos
AU - Abildgaard, Niels
AU - Abonour, Rafat
AU - Alsina, Melissa
AU - Anderson, Kenneth C.
AU - Attal, Michel
AU - Avet-Loiseau, Hervé
AU - Badros, Ashraf
AU - Bahlis, Nizar Jacques
AU - Barlogie, Bart
AU - Bataille, Régis
AU - Beksaç, Meral
AU - Belch, Andrew
AU - Ben-Yehuda, Dina
AU - Bensinger, Bill
AU - Leif Bergsagel, P.
AU - Bhutani, Manisha
AU - Bird, Jenny
AU - Bladé, Joan
AU - Broijl, Annemiek
AU - Boccadoro, Mario
AU - Caers, Jo
AU - Chanan-Khan, Asher
AU - Chari, Ajai
AU - Chen, Wen Ming
AU - Chesi, Marta
AU - Anthony Child, J.
AU - Chim, Chor Sang
AU - Chng, Wee Joo
AU - Leiba, Merav
N1 - Publisher Copyright:
© 2016 by American Society of Clinical Oncology.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - Purpose: The aim of the International Myeloma Working Group was to develop practical recommendations for the diagnosis and management of multiple myeloma–related renal impairment (RI). Methods: Recommendations were based on published data through December 2015, and were developed using the system developed by the Grading of Recommendation, Assessment, Development, and Evaluation Working Group. Recommendations: All patients with myeloma at diagnosis and at disease assessment should have serum creatinine, estimated glomerular filtration rate, and electrolytes measurements as well as free light chain, if available, and urine electrophoresis of a sample from a 24-hour urine collection (grade A). The Chronic Kidney Disease Epidemiology Collaboration, preferably, or the Modification of Diet in Renal Disease formula should be used for the evaluation of estimated glomerular filtration rate in patients with stabilized serum creatinine (grade A). International Myeloma Working Group criteria for renal reversibility should be used (grade B). For the management of RI in patients with multiple myeloma, high fluid intake is indicated along with antimyeloma therapy (grade B). The use of high-cutoff hemodialysis membranes in combination with antimyeloma therapy can be considered (grade B). Bortezomib-based regimens remain the cornerstone of the management of myeloma-related RI (grade A). High-dose dexamethasone should be administered at least for the first month of therapy (grade B). Thalidomide is effective in patients with myeloma with RI, and no dose modifications are needed (grade B). Lenalidomide is effective and safe, mainly in patients with mild to moderate RI (grade B); for patients with severe RI or on dialysis, lena-lidomide should be given with close monitoring for hematologic toxicity (grade B) with dose reduction as needed. High-dose therapy with autologous stem cell transplantation (with melphalan 100 mg/m2 to 140 mg/m2) is feasible in patients with RI (grade C). Carfilzomib can be safely administered to patients with creatinine clearance > 15 mL/min, whereas ixazomib in combination with lenalidomide and dex-amethasone can be safely administered to patients with creatinine clearance > 30 mL/min (grade A).
AB - Purpose: The aim of the International Myeloma Working Group was to develop practical recommendations for the diagnosis and management of multiple myeloma–related renal impairment (RI). Methods: Recommendations were based on published data through December 2015, and were developed using the system developed by the Grading of Recommendation, Assessment, Development, and Evaluation Working Group. Recommendations: All patients with myeloma at diagnosis and at disease assessment should have serum creatinine, estimated glomerular filtration rate, and electrolytes measurements as well as free light chain, if available, and urine electrophoresis of a sample from a 24-hour urine collection (grade A). The Chronic Kidney Disease Epidemiology Collaboration, preferably, or the Modification of Diet in Renal Disease formula should be used for the evaluation of estimated glomerular filtration rate in patients with stabilized serum creatinine (grade A). International Myeloma Working Group criteria for renal reversibility should be used (grade B). For the management of RI in patients with multiple myeloma, high fluid intake is indicated along with antimyeloma therapy (grade B). The use of high-cutoff hemodialysis membranes in combination with antimyeloma therapy can be considered (grade B). Bortezomib-based regimens remain the cornerstone of the management of myeloma-related RI (grade A). High-dose dexamethasone should be administered at least for the first month of therapy (grade B). Thalidomide is effective in patients with myeloma with RI, and no dose modifications are needed (grade B). Lenalidomide is effective and safe, mainly in patients with mild to moderate RI (grade B); for patients with severe RI or on dialysis, lena-lidomide should be given with close monitoring for hematologic toxicity (grade B) with dose reduction as needed. High-dose therapy with autologous stem cell transplantation (with melphalan 100 mg/m2 to 140 mg/m2) is feasible in patients with RI (grade C). Carfilzomib can be safely administered to patients with creatinine clearance > 15 mL/min, whereas ixazomib in combination with lenalidomide and dex-amethasone can be safely administered to patients with creatinine clearance > 30 mL/min (grade A).
UR - http://www.scopus.com/inward/record.url?scp=84965050407&partnerID=8YFLogxK
U2 - 10.1200/JCO.2015.65.0044
DO - 10.1200/JCO.2015.65.0044
M3 - Article
C2 - 26976420
AN - SCOPUS:84965050407
SN - 0732-183X
VL - 34
SP - 1544
EP - 1557
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 13
ER -