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Leuk Lymphoma. 2015;56(12):3357-64. doi: 10.3109/10428194.2015.1040011. Epub 2015 May 12.

Clinical and prognostic differences among patients with light chain deposition disease, myeloma cast nephropathy and both.

Author information

1
a Division of Nephrology and Hypertension , Rochester , MN , USA.
2
b Department of Laboratory Medicine and Pathology , Rochester , MN , USA.
3
c Division of Hematology, Mayo Clinic , Rochester , MN , USA.

Abstract

In some patients with light chain deposition disease (LCDD) there is also evidence of myeloma cast nephropathy (MCN) on renal biopsy. The purpose of this study was to evaluate the renal and survival outcome of patients with concomitant diagnosis of MCN and LCDD to LCDD and MCN alone. Eighty seven patients were identified and divided into LCDD (n=45), MCN (n=29), and LCDD+ MCN (n=13). Patients with LCDD+ MCN had a worse overall survival (OS) compared to patients with LCDD (p=0.03), but similar to patients with MCN (p=0.4). Death-censored renal survival was no different amongst the groups. Presenting with acute renal failure at time of renal biopsy (HR 7.2, p=0.0002) was an independent poor renal prognostic factor while older age (HR 1.06, p=0.0002), presence of osteolytic lesions (HR 4.4, p<0.0001), and requirement for dialysis or creatinine‚Č•5 mg/dL (HR 3.2, p=0.0006) at time of renal biopsy were independent poor prognostic factors for OS.

KEYWORDS:

Light chain deposition disease; multiple myeloma; myeloma cast nephropathy; renal disease

PMID:
25860232
DOI:
10.3109/10428194.2015.1040011
[Indexed for MEDLINE]

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