| Title: | Use of high- and medium-cut-off membrane hemodialysis for removal of free light chains in patients with multiple myeloma-a single-center experience |
|---|
| Authors: | ID Škerget, Matevž (Author)
ID Vajdič Trampuž, Barbara (Author)
ID Starman, Tajda (Author)
ID Gubenšek, Jakob (Author) |
|---|
| Files: |  PDF - Presentation file, download (494,12 KB)
MD5: 6F6BA6E622B9F8A0186E1853BAE914CC
 URL - Source URL, visit https://www.mdpi.com/2077-0383/15/8/2917
|
|---|
| Language: | English |
|---|
| Typology: | 1.01 - Original Scientific Article |
|---|
| Organization: |  UKC LJ - Ljubljana University Medical Centre
|
|---|
| Abstract: | Background/Objectives: Light-chain cast nephropathy remains a major cause of morbidity in newly diagnosed multiple myeloma (MM), and rapidly reducing circulating free light chains (FLCs) is considered essential for renal recovery and survival. Methods: We conducted a single-center retrospective study evaluating high- and medium-cut-off hemodialysis (HCO/MCO HD) in newly diagnosed MM patients presenting with acute kidney injury (AKI). Consecutive patients treated at the University Medical Center Ljubljana between 1 January 2020 and 31 December 2023 were included. As per institutional protocols, HCO/MCO HD- and myeloma-directed therapy were initiated on the day of diagnosis. Primary endpoints were the magnitude of FLC reduction, renal and hematologic responses at three months, and overall survival. Results: The median FLC concentration at presentation was 9630 mg/L. FLC levels declined rapidly after HCO/MCO HD initiation, reaching 2400 mg/L by day 7, 1083 mg/L by day 14, and 370 mg/L by day 30. MCO HD achieved kapa FLC clearance comparable to HCO HD for the lambda isotype. Despite a median of only four HCO/MCO-HD sessions, the reduction in FLC was rapid, with an additional decline observed over time, while the median FLC concentration fell below 500 mg/L. At three months, the overall hematologic response was 87%, including very good partial response or better in 35% of patients, and renal response in 79% of patients. Achieving a ≥70% FLC reduction by day 7 was associated with superior outcomes, including markedly longer median overall survival (82.5 vs. 23.2 months). Conclusions: Our data show that HCO/MCO-HD treatment alongside anti-myeloma therapy achieves sustained FLC reduction in newly diagnosed MM with AKI and early FLC reduction is highlighted as a key determinant of survival. |
|---|
| Keywords: | acute kidney injury, free light chains, high-cut-off dialysis, light chain cast nephropathy, medium-cut-off dialysis, myeloma |
|---|
| Publication status: | Published |
|---|
| Publication version: | Version of Record |
|---|
| Year of publishing: | 2026 |
|---|
| Number of pages: | str. 1-12 |
|---|
| Numbering: | Vol. 15, iss. 8, [article no.] 2917 |
|---|
| PID: | 20.500.12556/DiRROS-29614  |
|---|
| UDC: | 616.1/.4 |
|---|
| ISSN on article: | 2077-0383 |
|---|
| DOI: | 10.3390/jcm15082917 |
|---|
| COBISS.SI-ID: | 278979843 |
|---|
| Note: |
Nasl. z nasl. zaslona;
Opis vira z dne 21. 5. 2026;
|
|---|
| Publication date in DiRROS: | 01.06.2026 |
|---|
| Views: | 140 |
|---|
| Downloads: | 89 |
|---|
| Metadata: |    |
|---|
|
:
|
Copy citation |
|---|
| | | | Share: |  |
|---|
Hover the mouse pointer over a document title to show the abstract or click
on the title to get all document metadata. |
