New findings on disease characteristics of multiple myeloma patients with acute renal insufficiency: a ten- year retrospective study

Abstract

Background 48% of multiple myeloma patients will develop kidney damage, and its progression, survival, hematological characteristics, and cytokine characteristics have not yet been fully characterized. We aimed to describe subgroups of multiple myeloma with acute renal insufficiency and analyze associated predictors. Methods The patients with acute renal insufficiency were divided into one group, and the remaining were divided into another group. Risk factors were analyzed by comparing the baseline, progression-free survival, and survival outcomes between the two groups. 12 cytokines were detected by flow cytometry, and the relationship between cytokines and renal function was explored. Results 306 patients with multiple myeloma in Zhongnan Hospital of Wuhan University from 2011 to 2021 were enrolled, including 91 patients with acute renal insufficiency. The baseline of the two groups were well matched. ISS stage and immune typing are important predictors. With the advance of the disease course, the prediction ability of the initial disease stage to the prognosis decreased, but the prediction ability of WBC and β2-MG increased. IL-6 (P=0.001) and κ-light chain (P=0.006) were significantly elevated in patients with acute renal insufficiency, and were closely related to the severity of renal function deterioration (P<0.001). ConclusionsAcute renal insufficiency seriously affects the prognosis of myeloma patients, among which light chain is an important initiating factor. In addition to ISS staging and immunophenotyping, we propose for the first time the predictive value of leukocytes and IL-6 on disease course. And our study provides important evidence for the development of early blood purification therapy.