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Singh G, Savage NM, Jillella AP, et al. Light Chain-Predominant Multiple Myeloma Subgroup: Impaired Renal Function Correlates with Decreased Survival. Lab Med. 2021;doi: 10.1093/labmed/lmab054.
Singh, G., Savage, N. M., Jillella, A. P., & Bollag, R. J. (2021). Light Chain-Predominant Multiple Myeloma Subgroup: Impaired Renal Function Correlates with Decreased Survival. Laboratory medicine, . https://doi.org/10.1093/labmed/lmab054
Singh, Gurmukh, et al. "Light Chain-Predominant Multiple Myeloma Subgroup: Impaired Renal Function Correlates with Decreased Survival." Laboratory medicine vol. (2021). doi: https://doi.org/10.1093/labmed/lmab054
Singh G, Savage NM, Jillella AP, Bollag RJ. Light Chain-Predominant Multiple Myeloma Subgroup: Impaired Renal Function Correlates with Decreased Survival. Lab Med. 2021 Aug 13; doi: 10.1093/labmed/lmab054. Epub 2021 Aug 13. PMID: 34388245.
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Lab Med. 2021 Aug 13; doi: 10.1093/labmed/lmab054. Epub 2021 Aug 13.

Light Chain-Predominant Multiple Myeloma Subgroup: Impaired Renal Function Correlates with Decreased Survival.

Laboratory medicine

Gurmukh Singh, Natasha M Savage, Anand P Jillella, Roni J Bollag

Affiliations

  1. Division of Clinical Pathology, Department of Pathology, Medical College of Georgia at Augusta University, Augusta, Georgia, US.
  2. Division of Hematology/Oncology, Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia, US.

PMID: 34388245 DOI: 10.1093/labmed/lmab054

Abstract

OBJECTIVE: Patients with light chain-predominant multiple myeloma have been shown to exhibit shorter survival. Retrospective comparison of clinical and laboratory data was undertaken to ascertain the likely cause(s) of this observation.

METHODS: Records of patients with multiple myeloma seen at 1 institution revealed 316 patients with conventional and 71 patients with light chain-predominant multiple myelomas with secretion of intact immunoglobulins. Laboratory and clinical findings in the 2 groups were compared.

RESULTS: Patients with light chain-predominant multiple myeloma had a significantly higher death rate, a higher rate of chronic dialysis, a lower estimated glomerular filtration rate and serum albumin, a significantly higher urine protein concentration, and a significantly higher prevalence of hypertension and blood transfusion requirements. Other clinical and laboratory parameters surveyed were not significantly different between the 2 groups.

CONCLUSION: The shorter survival of patients with light chain-predominant multiple myeloma is clearly associated with renal damage caused by excess free immunoglobulin light chains. Renal damage may be ameliorated by early aggressive treatment with chemotherapy, plasmapheresis, and dialysis; a multi-institutional prospective controlled trial would be needed to test this hypothesis.

© American Society for Clinical Pathology, 2021. All rights reserved. For permissions, please e-mail: [email protected].

Keywords: cast nephropathy; eGFR; light chain–predominant multiple myeloma; multiple myeloma; serum free light chains; survival

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