Influence of Renal Impairment on Outcome of Patients with Multiple Myeloma: a Ten-Year Single Center Experience
Keywords:
renal impairment, multiple myeloma, NigeriaAbstract
Background: Renal impairment (RI) is an important complication occurring in 20 – 50% of newly diagnosed patients with multiple myeloma. It adversely affects overall survival and outcome in these patients. This study aims to assess RI in newly diagnosed multiple myeloma patients presenting at a tertiary hospital in the South-South region of Nigeria.
Methods: This was a ten-year retrospective study conducted on cases with confirmed multiple myeloma from August 2006 to July 2016. Renal impairment was determined using eGFR formula calculated by MDRD formula. Data analysis was done using statistical software package Microsoft Xcel® 2013.
Results: A total of 29 patients were diagnosed with MM within the period, with a male to female ratio of 1.9: 1. The median age at diagnosis was 60 years. Renal impairment occurred in 15 (51.7%) of cases. One (6.7%) patient presented with eGFR <15 signifying end stage renal disease requiring dialysis. Significantly more patients with lambda chain disease had RI compared to patients with kappa chain disease. Patients with RI were significantly more at risk of death than those with normal renal function [hazards ratio 12.1 at 95% CI; p = 0.03]. The group with RI had an estimated 5 year OS of 40.8% compared to those without RI who had an OS of 85.7%; (hazards ratio 2.46, at 95% CI).
Conclusion: Renal impairment remains a common presentation in patients newly diagnosed with multiple myeloma. The presence of RI at diagnosis is a poor prognostic feature affecting survival of myeloma cases.
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