Multiple Myeloma

Challenges in Multiple Myeloma: Renal Failure

How to Manage Common Challenging Situations in Patients With Multiple Myeloma: Management of Multiple Myeloma in Patients With Renal Failure

Speaker details: Dr. Francesca Gay

Renal failure is present in 20%–40% of newly diagnosed patients and, if severe, is associated with increased early death.18 Anti-MM treatment should start immediately to restore renal function, and further adverse events should be prevented and managed to optimize patient outcomes.

First-line treatment in patients with renal impairment should include a bortezomib-based strategy.¹⁹

Lenalidomide and pomalidomide can also be used safely.^20,21

The second-generation proteasome inhibitor carfilzomib is also effective, but careful monitoring of renal and cardiovascular toxicities is warranted.²²

The addition of monoclonal antibodies to novel agent combinations is safe and effective at both diagnosis and relapse.²³

In eligible patients, autologous stem cell transplant should be considered (even in dialysis-dependent patients).¹⁹