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NDT Plus Advance Access originally published online on February 14, 2008
NDT Plus 2008 1(2):106-108; doi:10.1093/ndtplus/sfm053
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Combination of bortezomib-based chemotherapy and extracorporeal free light chain removal for treating cast nephropathy in multiple myeloma

Ulrike Bachmann1, Ralf Schindler1, Markus Storr2, Andreas Kahl1, Achim Joerres1 and Isrid Sturm3

1 Department of Nephrology and Intensive Care Medicine, Charité-Campus Virchow-Clinic, Universitaetsmedizin, Berlin
2 Gambro Dialysatoren, Hechingen
3 Department of Hematology and Oncology, Charité-Campus Virchow-Clinic, Universitaetsmedizin, Berlin, Germany

Correspondence: R. Schindler, Department of Nephrology and Intensive Care Medicine, Charité, Campus Virchow-Klinikum, Augustenburger Platz 1, D-13353 Berlin, Germany. Tel: +49-030-450-553-232; Fax: +49-030-450-553-993; E-mail: ralf.schindler{at}charite.de


  Abstract

Besides amyloidosis and light chain deposition disease, the most common histological type of renal lesion is cast nephropathy in 30% of patients with multiple myeloma [2]. In contrast to amyloidosis, cast nephropathy is believed to be potentially reversible when circulating light chains are rapidly reduced. We report on three patients with multiple myeloma and cast nephropathy treated with a bortezomib-based chemotherapy in addition to a newly developed high-cutoff polyflux® haemofilter. Reduction in serum free light chain levels was achieved within 10–12 days, with all three patients improving their renal function.

Key Words: cast nephropathy • free light chains • haemodialysis • high cutoff • myeloma

Received for publication December 23, 2007. Accepted for publication December 26, 2007.


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