A study of 10 cases with multiple myeloma undergoing hemodialysis

This study was performed to investigate the therapeutic effects of hemodialysis (HD) on patients having multiple myeloma (MM) with renal failure. The subjects were 10 patients with MM undergoing HD. The ages ranged from 58 to 70 years old, and there were 7 males and 3 females. Two cases were IgG type, one IgA type, one IgD type, five Bence Jones protein (BJP) type, and one was non-secretary type. These cases were divided into three groups. Group A included patients dying within 1 month after initiation of HD therapy (n=6), group B consisted of patients dying within 1 year of maintenance HD (n=2), and group C of patients with long-term survival (over 5 years) (n=2). In group A, renal failure resulted from BJP, amyloidosis, and hypercalcemia. The causes of death were infection, heart failure, arrhythmia, and DIC. In group B, one patient died from hepatic failure, 8 months after HD treatment, and another patient, though compensated for cessation of HD, died from arrhythmia 11 months later. In group C, a patient affected with non-secretary type MM has received HD for 6 years. Another patient was started on HD because of hyperviscosity, and HD and plasma exchange provided substantial recovery of renal function. We conclude that it is not easy to estimate prognosis at the time of HD introduction. It is important to prevent lethal complications, and to initiate intensive chemotherapy and early HD therapy, in order to improve the prognoses of MM patients suffering from renal failure.