Department of Hematology, Tianjin Medical University General Hospital, Tianjin, China.
J Clin Lab Anal. 2019 Jun;33(5):e22888. doi: 10.1002/jcla.22888. Epub 2019 Apr 19.
Renal impairment (RI) is a most common complication of multiple myeloma (MM), which is associated with an increased risk of early death and worse survival.
We retrospectively analyzed clinical features and outcomes of 77 MM patients over 70 years old and compared the differences between with and without RI groups.
The percentage of elder MM patients with RI was 61%. Hemoglobin level was a protective factor (OR = 0.954, P = 0.033), while creatinine and hypertension were hazards (OR = 1.288, P < 0.001 and OR = 30.12, P = 0.008). And the percentages of patients with mild-to-moderate RI and moderate-to-severe RI were 40.4% and 59.6%. Complete remission (CR) rate was higher in patients treated with bortezomib (33.3%) than those with non-bortezomib treatment (3.33%) (P = 0.007). Meanwhile, CRrenal was higher in patients with bortezomib (58.3%) than non-bortezomib treatment (22.2%) (P = 0.025). The median OS of the patients with RI treated with bortezomib was longer than those with non-bortezomib regimens (15.0 vs 6.0 months, P = 0.001). The same result was observed in the patients with moderate-to-severe RI (13.0 vs 6.0 months, P = 0.007). The median OS of the patients with RI receiving the bortezomib regimens (15 months) was longer than those with non-bortezomib regimens (6.0 months) (P = 0.001).
Hemoglobin is a protective factor in elder patients with RI, while creatinine and hypertension were hazards. The median OS of elderly patients with RI was worse, and bortezomib can improve the CR rate in these patients.
肾功能不全（RI）是多发性骨髓瘤（MM）最常见的并发症，与早期死亡风险增加和生存状况恶化相关。
我们回顾性分析了 77 例 70 岁以上 MM 患者的临床特征和结局，并比较了 RI 组与非 RI 组之间的差异。
老年 MM 患者 RI 发生率为 61%。血红蛋白水平是一个保护因素（OR=0.954，P=0.033），而肌酐和高血压是危险因素（OR=1.288，P<0.001 和 OR=30.12，P=0.008）。轻度至中度 RI 和中度至重度 RI 患者的比例分别为 40.4%和 59.6%。硼替佐米治疗患者的完全缓解（CR）率（33.3%）高于非硼替佐米治疗患者（3.33%）（P=0.007）。同时，硼替佐米治疗患者的 CRrenal 更高（58.3%）而非硼替佐米治疗患者（22.2%）（P=0.025）。RI 患者接受硼替佐米治疗的中位 OS 长于非硼替佐米治疗（15.0 与 6.0 个月，P=0.001）。在 RI 中、重度患者中也观察到相同的结果（13.0 与 6.0 个月，P=0.007）。接受硼替佐米方案治疗的 RI 患者的中位 OS（15 个月）长于非硼替佐米方案（6.0 个月）（P=0.001）。
血红蛋白是 RI 老年患者的保护因素，而肌酐和高血压是危险因素。RI 老年患者的中位 OS 更差，硼替佐米可改善这些患者的 CR 率。
