Hematologic and renal improvement of monoclonal immunoglobulin deposition disease after treatment with bortezomib-based regimens.
Τίτλος | Hematologic and renal improvement of monoclonal immunoglobulin deposition disease after treatment with bortezomib-based regimens. |
Publication Type | Journal Article |
Year of Publication | 2017 |
Authors | Ziogas, D. C., Kastritis E., Terpos E., Roussou M., Migkou M., Gavriatopoulou M., Spanomichou D., Eleutherakis-Papaiakovou E., Fotiou D., Panagiotidis I., Kafantari E., Psimenou E., Boletis I., Vlahakos D. V., Gakiopoulou H., Matsouka C., & Dimopoulos M. A. |
Journal | Leuk Lymphoma |
Volume | 58 |
Issue | 8 |
Pagination | 1832-1839 |
Date Published | 2017 08 |
ISSN | 1029-2403 |
Λέξεις κλειδιά | Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols, Biomarkers, Biopsy, Bortezomib, Female, Hematologic Diseases, Humans, Immunoglobulin Heavy Chains, Immunoglobulin Light Chains, Kidney Diseases, Kidney Function Tests, Male, Middle Aged, Paraproteinemias, Treatment Outcome |
Abstract | Monoclonal immunoglobulin deposition disease (MIDD) is characterized by non-organized immunoglobulin-fragments along renal basement membranes with subsequent organ deterioration. Treatment is directed against the immunoglobulin-producing clone. We treated 18 MIDD patients with bortezomib-based regimens (12 received bortezomib-dexamethasone, 6 bortezomib-dexamethasone with cyclophosphamide). Eleven (61%) patients achieved a hematologic response, but only 6 (33.3%) reached to a complete (CR) or very good partial response (VGPR). Regarding renal outcomes 77.8 and 55.6% had ≥30 and ≥50% reduction of proteinuria, respectively, but 33.3% ended up in end-stage renal disease (ESRD). Among patients with CR or VGPR, median eGFR improvement was 7.7 ml/min/1.73 m and none progressed to ESRD, but no significant renal recovery was observed in patients achieving a partial response or less, with 50% progressing to dialysis. Pretreatment eGFR seems to influence renal prognosis. Bortezomib-based treatment is considered an effective approach in MIDD and reaching to a deep hematologic response (≥VGPR) conditionally controls further renal declining. |
DOI | 10.1080/10428194.2016.1267349 |
Alternate Journal | Leuk. Lymphoma |
PubMed ID | 27967286 |