Al-Ola A Abdallah: Clinicopathologic Predictors of Renal Response and Survival in NDMM with Renal Impairment
Al-Ola A Abdallah, Associate Professor and Plasma Cell disorder program Director at University of Kansas Medical Center, shared a post on X:
“Clinicopathologic Predictors of Renal Response and Survival in Newly Diagnosed MM (NDMM) with Renal Impairment (RI).
The study a retrospective observational study analyzing data from 647 NDMM patients treated at a single center in Shanghai, China between 2013 & 2023.
Aims to:
1)Identify clinicopathological factors associated w RI incidence,
2)renal response to treatment,
3)OS in NDMM pts &
4)to develop a model to predict RI response.”
RI affects 20-40% of NDMM:
Risk Factors for RI Incidence:
1) IgG type secreted monoclonal immunoglobulin.
2) Deregulated serum free κ/λ light chain.
3) Elevated serum calcium.
4) Elevated urea.
5) Elevated uric acid.
6) ISS (International Staging System) Stage III.
“A predictive model for RI response uses 5 clinical variables:
– Calcium level.
– Durie-Salmon stage.
– Cr level before treatment.
– Age .
– Gender.
The model achieved an accuracy of 72.99% in the training group and 69.57% in the validation group.
Factors Affecting OS in NDMM Patients with RI:
1) Age ≥ 65 years.
2) β2-microglobulin level ≥ 5.5 mg/L.
3) del(13q) chromosomal deletion.
4) LDH level ≥ 250 U/L.
5) Elevated urinary albumin/creatinine ratio (≥ 30 mg/g).
6) Pre-treatment Cr level > 369 μmol/L Cr CKD stage G4-G5.
7) Lack of renal response to treatment.
8) ISS Stage III.
Limitations:
- Single-center retrospective study, limiting generalizability.
- Relatively small sample size for the renal impairment cohort (n=193).
- Lack of mutation, transcriptome, proteomics, or biopsy data.”
The prediction model for RI response is still questionable, although it may show potential.”
Clinicopathologic predictors of renal response and survival in newly diagnosed multiple myeloma with renal injury: a retrospective study.
Authors: Wei Wei, et al.
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