Incidence, prognostic impact and clinical outcomes of renal impairment in patients with multiple myeloma: a population-based registry
Abstract Background Renal impairment (RI), a severe complication in multiple myeloma (MM), is considered as a poor prognostic factor. Patient survival has increased with the use of novel drugs and autologous stem-cell transplantation (ASCT). However, specific evolution of the incidence of RI in MM a...
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| Veröffentlicht in: | Nephrology, dialysis, transplantation dialysis, transplantation, 2021-02, Vol.36 (3), p.482-490 |
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| creator | Courant, Maxime Orazio, Sebastien Monnereau, Alain Preterre, Julie Combe, Christian Rigothier, Claire |
| description | Abstract
Background
Renal impairment (RI), a severe complication in multiple myeloma (MM), is considered as a poor prognostic factor. Patient survival has increased with the use of novel drugs and autologous stem-cell transplantation (ASCT). However, specific evolution of the incidence of RI in MM and its impact on prognosis remain unclear.
Methods
Using a population-based registry of 1038 newly diagnosed MM in Gironde, France, we evaluated the incidence trends of RI in MM patients and assessed net survival according to factors of interest using Pohar-Perme indicator and excess mortality rate regression. We also reviewed 114 cases of MM with RI to describe their clinical outcomes.
Results
In our population-based study, 24.6% of MM patients presented with RI (12.9% required haemodialysis). Median survival time was 21 months in patients with RI versus not reached at 3 years for other patients (P 73 years, RI, comorbidities and non-use of drugs or ASCT were associated with excess mortality risk. The effect of RI on excess mortality rates was maximum in the first 6 months after diagnosis. In the observational study, median follow-up time was 22.5 months; factors associated with renal response were haematologic response [odds ratio (OR) 6.81; P |
| doi_str_mv | 10.1093/ndt/gfz211 |
| format | Article |
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Background
Renal impairment (RI), a severe complication in multiple myeloma (MM), is considered as a poor prognostic factor. Patient survival has increased with the use of novel drugs and autologous stem-cell transplantation (ASCT). However, specific evolution of the incidence of RI in MM and its impact on prognosis remain unclear.
Methods
Using a population-based registry of 1038 newly diagnosed MM in Gironde, France, we evaluated the incidence trends of RI in MM patients and assessed net survival according to factors of interest using Pohar-Perme indicator and excess mortality rate regression. We also reviewed 114 cases of MM with RI to describe their clinical outcomes.
Results
In our population-based study, 24.6% of MM patients presented with RI (12.9% required haemodialysis). Median survival time was 21 months in patients with RI versus not reached at 3 years for other patients (P < 0.01). Age >73 years, RI, comorbidities and non-use of drugs or ASCT were associated with excess mortality risk. The effect of RI on excess mortality rates was maximum in the first 6 months after diagnosis. In the observational study, median follow-up time was 22.5 months; factors associated with renal response were haematologic response [odds ratio (OR) 6.81; P < 0.01] and previous chronic kidney disease (OR 0.26; P = 0.04). Factors associated with 1-year overall survival were haematological [hazard ratio (HR) 0.13; P < 0.01] and renal response (HR 0.27; P = 0.03).
Conclusions
RI represents an independent negative prognostic factor in MM in the first 6 months after diagnosis. Renal recovery and haematologic response are the strongest markers associated with patient survival.</description><identifier>ISSN: 0931-0509</identifier><identifier>EISSN: 1460-2385</identifier><identifier>DOI: 10.1093/ndt/gfz211</identifier><identifier>PMID: 31773154</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Aged ; Aged, 80 and over ; Female ; France - epidemiology ; Humans ; Incidence ; Life Sciences ; Male ; Middle Aged ; Multiple Myeloma - complications ; Prognosis ; Registries - statistics & numerical data ; Renal Insufficiency - epidemiology ; Renal Insufficiency - etiology ; Renal Insufficiency - mortality ; Renal Insufficiency - pathology ; Retrospective Studies ; Santé publique et épidémiologie ; Survival Rate</subject><ispartof>Nephrology, dialysis, transplantation, 2021-02, Vol.36 (3), p.482-490</ispartof><rights>The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. 2019</rights><rights>The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c351t-d88be52030362504b4a260576bb7ff1591cd4a52033a130909f3192f9bf2c3523</citedby><cites>FETCH-LOGICAL-c351t-d88be52030362504b4a260576bb7ff1591cd4a52033a130909f3192f9bf2c3523</cites><orcidid>0000-0002-0360-573X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,1578,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31773154$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-03269065$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Courant, Maxime</creatorcontrib><creatorcontrib>Orazio, Sebastien</creatorcontrib><creatorcontrib>Monnereau, Alain</creatorcontrib><creatorcontrib>Preterre, Julie</creatorcontrib><creatorcontrib>Combe, Christian</creatorcontrib><creatorcontrib>Rigothier, Claire</creatorcontrib><title>Incidence, prognostic impact and clinical outcomes of renal impairment in patients with multiple myeloma: a population-based registry</title><title>Nephrology, dialysis, transplantation</title><addtitle>Nephrol Dial Transplant</addtitle><description>Abstract
Background
Renal impairment (RI), a severe complication in multiple myeloma (MM), is considered as a poor prognostic factor. Patient survival has increased with the use of novel drugs and autologous stem-cell transplantation (ASCT). However, specific evolution of the incidence of RI in MM and its impact on prognosis remain unclear.
Methods
Using a population-based registry of 1038 newly diagnosed MM in Gironde, France, we evaluated the incidence trends of RI in MM patients and assessed net survival according to factors of interest using Pohar-Perme indicator and excess mortality rate regression. We also reviewed 114 cases of MM with RI to describe their clinical outcomes.
Results
In our population-based study, 24.6% of MM patients presented with RI (12.9% required haemodialysis). Median survival time was 21 months in patients with RI versus not reached at 3 years for other patients (P < 0.01). Age >73 years, RI, comorbidities and non-use of drugs or ASCT were associated with excess mortality risk. The effect of RI on excess mortality rates was maximum in the first 6 months after diagnosis. In the observational study, median follow-up time was 22.5 months; factors associated with renal response were haematologic response [odds ratio (OR) 6.81; P < 0.01] and previous chronic kidney disease (OR 0.26; P = 0.04). Factors associated with 1-year overall survival were haematological [hazard ratio (HR) 0.13; P < 0.01] and renal response (HR 0.27; P = 0.03).
Conclusions
RI represents an independent negative prognostic factor in MM in the first 6 months after diagnosis. Renal recovery and haematologic response are the strongest markers associated with patient survival.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Female</subject><subject>France - epidemiology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Life Sciences</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multiple Myeloma - complications</subject><subject>Prognosis</subject><subject>Registries - statistics & numerical data</subject><subject>Renal Insufficiency - epidemiology</subject><subject>Renal Insufficiency - etiology</subject><subject>Renal Insufficiency - mortality</subject><subject>Renal Insufficiency - pathology</subject><subject>Retrospective Studies</subject><subject>Santé publique et épidémiologie</subject><subject>Survival Rate</subject><issn>0931-0509</issn><issn>1460-2385</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1v1DAQhi1ERZfChR-AfEEC1NCxHSfr3qoKaKWVeoGz5Tj21sgfIXZAy73_G69SeuQ0o5lHz0jzIvSGwCcCgl3EsVzs7R9KyDO0IW0HDWVb_hxt6pI0wEGcopc5_wAAQfv-BTplpO8Z4e0GPdxG7UYTtTnH05z2MeXiNHZhUrpgFUesvYtOK4_TUnQKJuNk8WxinRwpNwcTC3YRT6q42mb825V7HBZf3OQNDgfjU1CXWOEpTYuvVIrNoLIZq2bvcpkPr9CJVT6b14_1DH3_8vnb9U2zu_t6e321azTjpDTjdjsYToEB6yiHdmgV7YD33TD01hIuiB5bdQSYIgwECMuIoFYMllYDZWfow-q9V15OswtqPsiknLy52snjDBjtBHT8F6ns-5Wtb_m5mFxkcFkb71U0acmSVjURrB6t6McV1XPKeTb2yU1AHiOSNSK5RlTht4_eZQhmfEL_ZVKBdyuQlul_or_QzJqk</recordid><startdate>20210220</startdate><enddate>20210220</enddate><creator>Courant, Maxime</creator><creator>Orazio, Sebastien</creator><creator>Monnereau, Alain</creator><creator>Preterre, Julie</creator><creator>Combe, Christian</creator><creator>Rigothier, Claire</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0002-0360-573X</orcidid></search><sort><creationdate>20210220</creationdate><title>Incidence, prognostic impact and clinical outcomes of renal impairment in patients with multiple myeloma: a population-based registry</title><author>Courant, Maxime ; Orazio, Sebastien ; Monnereau, Alain ; Preterre, Julie ; Combe, Christian ; Rigothier, Claire</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c351t-d88be52030362504b4a260576bb7ff1591cd4a52033a130909f3192f9bf2c3523</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Female</topic><topic>France - epidemiology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Life Sciences</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multiple Myeloma - complications</topic><topic>Prognosis</topic><topic>Registries - statistics & numerical data</topic><topic>Renal Insufficiency - epidemiology</topic><topic>Renal Insufficiency - etiology</topic><topic>Renal Insufficiency - mortality</topic><topic>Renal Insufficiency - pathology</topic><topic>Retrospective Studies</topic><topic>Santé publique et épidémiologie</topic><topic>Survival Rate</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Courant, Maxime</creatorcontrib><creatorcontrib>Orazio, Sebastien</creatorcontrib><creatorcontrib>Monnereau, Alain</creatorcontrib><creatorcontrib>Preterre, Julie</creatorcontrib><creatorcontrib>Combe, Christian</creatorcontrib><creatorcontrib>Rigothier, Claire</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>Nephrology, dialysis, transplantation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Courant, Maxime</au><au>Orazio, Sebastien</au><au>Monnereau, Alain</au><au>Preterre, Julie</au><au>Combe, Christian</au><au>Rigothier, Claire</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Incidence, prognostic impact and clinical outcomes of renal impairment in patients with multiple myeloma: a population-based registry</atitle><jtitle>Nephrology, dialysis, transplantation</jtitle><addtitle>Nephrol Dial Transplant</addtitle><date>2021-02-20</date><risdate>2021</risdate><volume>36</volume><issue>3</issue><spage>482</spage><epage>490</epage><pages>482-490</pages><issn>0931-0509</issn><eissn>1460-2385</eissn><abstract>Abstract
Background
Renal impairment (RI), a severe complication in multiple myeloma (MM), is considered as a poor prognostic factor. Patient survival has increased with the use of novel drugs and autologous stem-cell transplantation (ASCT). However, specific evolution of the incidence of RI in MM and its impact on prognosis remain unclear.
Methods
Using a population-based registry of 1038 newly diagnosed MM in Gironde, France, we evaluated the incidence trends of RI in MM patients and assessed net survival according to factors of interest using Pohar-Perme indicator and excess mortality rate regression. We also reviewed 114 cases of MM with RI to describe their clinical outcomes.
Results
In our population-based study, 24.6% of MM patients presented with RI (12.9% required haemodialysis). Median survival time was 21 months in patients with RI versus not reached at 3 years for other patients (P < 0.01). Age >73 years, RI, comorbidities and non-use of drugs or ASCT were associated with excess mortality risk. The effect of RI on excess mortality rates was maximum in the first 6 months after diagnosis. In the observational study, median follow-up time was 22.5 months; factors associated with renal response were haematologic response [odds ratio (OR) 6.81; P < 0.01] and previous chronic kidney disease (OR 0.26; P = 0.04). Factors associated with 1-year overall survival were haematological [hazard ratio (HR) 0.13; P < 0.01] and renal response (HR 0.27; P = 0.03).
Conclusions
RI represents an independent negative prognostic factor in MM in the first 6 months after diagnosis. Renal recovery and haematologic response are the strongest markers associated with patient survival.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>31773154</pmid><doi>10.1093/ndt/gfz211</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-0360-573X</orcidid></addata></record> |
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| subjects | Aged Aged, 80 and over Female France - epidemiology Humans Incidence Life Sciences Male Middle Aged Multiple Myeloma - complications Prognosis Registries - statistics & numerical data Renal Insufficiency - epidemiology Renal Insufficiency - etiology Renal Insufficiency - mortality Renal Insufficiency - pathology Retrospective Studies Santé publique et épidémiologie Survival Rate |
| title | Incidence, prognostic impact and clinical outcomes of renal impairment in patients with multiple myeloma: a population-based registry |
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