MP104
MULTIPLE MYELOMA AND RENAL IMPAIRMENT. A SERIES OF 162 PATIENTS Free

Introduction and Aims: Multiple myeloma accounts for 80% of monoclonal gammapathies. Renal impairement occurs frequently whether in diagnosis or in the course of the disease. Our aim was to study the epidemiological, clinical and therapeutic charasteristics of patients with multiple myeloma associated with renal impairment.

Methods: We reviewed the cases of patients admitted in our department and having multiple myeloma with renal impairment between 1974 and 2015.

Results: We exploited data from the medical records of 162 patients. The sex-ratio is 1,1. The mean age is 63 years-old [31- 86]. Smoking patients represent 33%. Deterioration of the general status is reported in only 20% of the cases in diagnosis. The mean serum creatinine level is 680 µmol/l [50- 2960], serum calcium level is 2,43 mmol/l [1,35- 3,75], hemoglobin concentration is 8,8 g/dl [3- 15] and platelet count is 208000/ mm³ [100000- 571000]. Lymphocyte proliferation varies from 6 to 100%, bone marrow biopsy being necessary in doubtful cases. 28 cases are light- chains myeloma. 3 cases are IgD myeloma. 43 patients undertook a kidney biopsy and had: a monoclonal immunoglobulin deposition disease (Randall type) in 5 cases, renal amyloidosis in 9 cases and renal tubulopathy in the remaining cases. The majority of patients were treated with a combination of melphalan/ prednisone and thalidomide, 2 with cyclophosphamide/ dexamethasone and 2 others with bortezomib/dexamethasone. Infectious complications occurred in 115 patients (71%). 61 patients (37%) died during the follow-up (mean of follow-up: 1- 62 months).

Conclusions: Multiple myeloma is a serious disease with a bad prognosis, especially when associated with a renal impairment. The new treatment options particularly bortezomib, seem quite promising compared to the standard protocol of alkylating agents ans steroids.