NEW HAEMODIALYSIS TREATMENTS FOR REMOVAL OF IMMUNOGLOBULIN FREE LIGHT CHAINS IN PATIENTS WITH MULTIPLE MYELOMA AND ACUTE RENAL FAILURE

Aim: Acute renal failure (ARF) in multiple myeloma (MM) occurs in 12-20% of patients representing a poor prognostic factor for patients survival. It has been demonstrated that early reduction of immunoglobulin free light chains (sFLC) can lead to a higher proportion of patients recovering renal func...

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Bibliographic Details
Published in:International journal of artificial organs 2014-01, Vol.37 (8), p.620-621
Main Authors: Apponi, F, Festuccia, F, Fofi, C, Barberi, S, Antolino, G, La Verde, G, Punzo, G, Mene, P
Format: Article
Language:English
Subjects:
Chemotherapy
Cut-off
Failure
Haemodialysis
Immunoglobulins
Patients
Reduction
Renal function
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Summary:Aim: Acute renal failure (ARF) in multiple myeloma (MM) occurs in 12-20% of patients representing a poor prognostic factor for patients survival. It has been demonstrated that early reduction of immunoglobulin free light chains (sFLC) can lead to a higher proportion of patients recovering renal function with a better outcome, especially if high cut-off haemodialysis combined with chemotherapy is used. However, no data is available regarding other adsorption-based techniques. such as haemodiafiltration with ultrafiltrate regeneration by adsorption with resins (SUPRA-HFR). We evaluated the effectiveness of this technique in the reduction of sFLC. Methods: We report five cases of MM (two IgG kappa, one IgA kappa, one IgA lambda, one kappa micromolecular myeloma). All patients were treated with chemotherapy and SUPRA-HFR. Levels of sFLC were assessed before and after dialysis and removal was calculated. Results: The mean reduction rate of sFLC was 34%, 59%, 43% and 44% (MM kappa) and 67% (MM lambda). Conclusions: Our study suggests that SUPRA-HFR provides effective reduction of plasma sFLC. When combined with chemotherapy and an early treatment start, it may allows the recovery of renal function, as occurred in one case of our small series.
ISSN:0391-3988
DOI:10.5301/ijao.5000347