[Current approaches to treating of patients with multiple myeloma with renal failure: Questions and proofs]

Area of Science:

• Nephrology
• Hematology
• Oncology

Background:

• Renal failure (RF) is a common complication in multiple myeloma (MM), affecting 20-30% at diagnosis and up to 50% during disease progression.
• Despite advances in MM treatment, patients with RF, particularly severe cases, are often underrepresented in clinical trials.
• Existing data on MM treatment in RF patients are limited, often lacking morphological diagnosis and showing variable renal response rates.

Purpose of the Study:

• To review and analyze the efficacy of current therapeutic strategies for multiple myeloma (MM) patients with renal failure (RF).
• To provide evidence-based recommendations for managing MM patients with RF, aligning with national and international treatment guidelines.

Main Methods:

• Systematic review of major clinical studies and investigations concerning multiple myeloma (MM) and renal failure (RF).
• Analysis of treatment outcomes in MM patients with varying degrees of RF, considering available data on nephropathies.
• Synthesis of findings to formulate clinical recommendations for MM management in the context of RF.

Main Results:

• Significant disparities in reported renal response rates exist due to variations in patient cohorts and diagnostic criteria.
• New therapeutic agents offer expanded treatment possibilities for MM, but their impact on RF patients requires further investigation.
• Limited data exists specifically for severe RF patients, highlighting a gap in current research.

Conclusions:

• Standardized approaches and further research are crucial for optimizing MM treatment in patients with renal complications.
• Treatment recommendations should consider the severity of RF and incorporate morphological assessment of kidney involvement.
• Integrating new MM therapies with supportive renal care is essential for improving outcomes in this vulnerable patient population.