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Multiple myeloma with acute light chain cast nephropathy

Light chain cast nephropathy (LCCN) is a leading cause of acute kidney injury (AKI) in patients with multiple myeloma (MM) and is now defined as a myeloma defining event. While the long-term prognosis has improved with novel agents, short-term mortality remains significantly higher in patients with...

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Autores principales: Leung, Nelson, Rajkumar, S. Vincent
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10060259/
https://www.ncbi.nlm.nih.gov/pubmed/36990996
http://dx.doi.org/10.1038/s41408-023-00806-w
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author Leung, Nelson
Rajkumar, S. Vincent
author_facet Leung, Nelson
Rajkumar, S. Vincent
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description Light chain cast nephropathy (LCCN) is a leading cause of acute kidney injury (AKI) in patients with multiple myeloma (MM) and is now defined as a myeloma defining event. While the long-term prognosis has improved with novel agents, short-term mortality remains significantly higher in patients with LCCN especially if the renal failure is not reversed. Recovery of renal function requires a rapid and significant reduction of the involved serum free light chain. Therefore, proper treatment of these patients is of the utmost importance. In this paper, we provide an algorithm for treatment of MM patients who present with biopsy-proven LCCN or in those where other causes of AKI have been ruled out. The algorithm is based on data from randomized trial whenever possible. When trial data is not available, our recommendations is based on non-randomized data and expert opinions on best practices. We recommend that all patients should enroll in a clinical trial if available prior to resorting to the treatment algorithm we outlined.
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spelling pubmed-100602592023-03-31 Multiple myeloma with acute light chain cast nephropathy Leung, Nelson Rajkumar, S. Vincent Blood Cancer J Current Treatment Algorithm Light chain cast nephropathy (LCCN) is a leading cause of acute kidney injury (AKI) in patients with multiple myeloma (MM) and is now defined as a myeloma defining event. While the long-term prognosis has improved with novel agents, short-term mortality remains significantly higher in patients with LCCN especially if the renal failure is not reversed. Recovery of renal function requires a rapid and significant reduction of the involved serum free light chain. Therefore, proper treatment of these patients is of the utmost importance. In this paper, we provide an algorithm for treatment of MM patients who present with biopsy-proven LCCN or in those where other causes of AKI have been ruled out. The algorithm is based on data from randomized trial whenever possible. When trial data is not available, our recommendations is based on non-randomized data and expert opinions on best practices. We recommend that all patients should enroll in a clinical trial if available prior to resorting to the treatment algorithm we outlined. Nature Publishing Group UK 2023-03-29 /pmc/articles/PMC10060259/ /pubmed/36990996 http://dx.doi.org/10.1038/s41408-023-00806-w Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Current Treatment Algorithm
Leung, Nelson
Rajkumar, S. Vincent
Multiple myeloma with acute light chain cast nephropathy
title Multiple myeloma with acute light chain cast nephropathy
title_full Multiple myeloma with acute light chain cast nephropathy
title_fullStr Multiple myeloma with acute light chain cast nephropathy
title_full_unstemmed Multiple myeloma with acute light chain cast nephropathy
title_short Multiple myeloma with acute light chain cast nephropathy
title_sort multiple myeloma with acute light chain cast nephropathy
topic Current Treatment Algorithm
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10060259/
https://www.ncbi.nlm.nih.gov/pubmed/36990996
http://dx.doi.org/10.1038/s41408-023-00806-w
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