Outcomes following Treatment with Bortezomib in Patients with Multiple Myeloma Who Required Haemodialysis: A Single-Centre Experience

Background: Renal impairment is a common complication of multiple myeloma (MM). About 10% present with acute kidney injury (AKI) needing haemodialysis (HD). Renal impairment is associated with increased morbidity and mortality. Bortezomib has resulted in a significant improvement in survival in comparison to other treatments. We looked at the survival and outcome of myeloma patients treated with Bortezomib, who also required HD during their treatment. Methods: We analysed data from our electronic database on patients diagnosed with MM with associated renal impairment between 2010 to 2024. Patients who had HD at presentation, or after diagnosis of myeloma were included. Analyses were performed using Microsoft Excel and R. Results: There were 116 patients. 68 (58.62 %) had HD. 62 (92%) received Bortezomib. Median age at diagnosis was 70 years (range 49-89 years), male to female ratio was 2.4:1. Median creatinine at initiation of HD was 645.5µmol/l. 20 (33%) recovered renal function. Median creatinine at stopping HD was 418µmol/L. Median duration on HD among patients who recovered function was 22.5 days. Survival at 3, 6 and 12 months was 90.4%, 90.4% and 70% respectively in patients who recovered renal function. In those who did not recover function, the 3, 6 and 12 month survival was 68%, 60.9% and 53.6% respectively. Survival in both groups is shown in the Kaplan Meier curve below. Conclusion: In our patients, a significant proportion of those who had Bortezomib regained kidney function. Recovery occurred in most patients within 4 weeks, and was associated with improved survival at 3, 6 and 12 months. Newer agents available to patients with myeloma and severe kidney disease are likely to improve outcomes.Survival of patients with recovered or non-recovered Renal function