Table 1.
Baseline Characteristics (N=34)
| Age (median, IQR) | 49.5 (44–59) |
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| |
| Sex, n (%) | |
| Male | 20 (59) |
| Female | 14 (41) |
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| Race, n (%) | |
| White | 28 (82) |
| African American | 6 (18) |
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| Hypertension, n (%) | 23 (68) |
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| Hematologic characteristics | |
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| Involved serum free light chain isotype, n (%) | |
| Kappa | 31 (91) |
| Lambda | 2 (6) |
| Kappa & Lambda | 1 (3) |
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| MIDD subtype, n (%) | |
| HCDD | 2 (6) |
| LCDD | 31 (91) |
| LHCDD | 1 (3) |
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| |
| Involved FLC level, mg/dL (median, IQR) | 129.3 (31.9–291) |
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| |
| Involved/Uninvolved free light chain ratio (median, IQR) | 69.28 (14.2–206.1) |
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| |
| Serum M-protein, g/dL (median, IQR) | 0 (0–0.3) |
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| |
| Bone marrow plasmacytosis, % (median, IQR) | 20 (12.75–30) |
| Patients with bone marrow plasmacytosis ≧ 10%, n (%) | 26 (77) |
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| |
| Serum albumin, g/dL (median, IQR) | 3.95 (3.5–4.2) |
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| |
| β2 microglobulin, mg/L (median, IQR) | 5.6 (4.5–8.65) |
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| ISS stage, n (%) | |
| I | 5 (15) |
| II | 9 (26) |
| II | 15 (44) |
| Not available | 5 (15) |
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| Lactate dehydrogenase, U/L (median, IQR) | 196 (168–216) |
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| Associated hematologic diagnosis, n (%) | |
| Multiple myeloma meeting IMWG criteria aside from eGFR | 25 (74) |
| Smoldering myeloma | 3 (9) |
| MGUS | 4 (12) |
| Chronic lymphocytic leukemia | 1 (3) |
| Waldenstrom macroglobulinemia + plasma cell dyscrasia | 1 (3) |
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| Patients meeting 2014 IMWG Revised Myeloma Defining Criteria excluding renal criterion, n (%) | |
| Hypercalcemia* | 1 (3) |
| Anemia with hemoglobin <10 g/dL | 15 (44) |
| Anemia with hemoglobin 2 g/dL below normal range** | 3 (9) |
| Osteolytic bone lesions on imaging | 11 (32) |
| Involved/Uninvolved serum FLC ratio >100 | 12 (35) |
| Clonal bone marrow plasmacytosis ≥ 60% | 3 (9) |
| Patients with ≥1 IMWG criteria for MM (excluding renal criterion) | 25 (74) |
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| Renal characteristics | |
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| Estimated GFR (eGFR) by CKD-EPI prior to treatment (median, IQR) | 23.2 (10.9–42.1) |
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| Dialysis prior to treatment, n (%) | 7 (21) |
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| 24-hr urine protein, mg/24 h (median, IQR) | 2700 (525.15–5840) |
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| Nephrotic-range proteinuria (≥3 g urine protein/24 h), n (%) | 15 (44) |
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| Hematuria at diagnosis, n (%) | 5 (15) |
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| Treatment characteristics | |
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| Bortezomib-based therapy, n (%) | 19 (56) |
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| Lenalidomide-based therapy, n (%) | 7 (21) |
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| Cyclophosphamide, n (%) | 8 (26) |
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| Dexamethasone alone | 5(15) |
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| Melphalan + ASCT, n (%) | 23 (68) |
CDK-EPI, Chronic Kidney Disease Epidemiology Collaboration; FLC, free light chain; HCDD, heavy chain deposition disease; IQR, interquartile range; LCDD, light chain deposition disease; LHCDD, light and/or heavy chain deposition disease; MIDD; monoclonal immunoglobulin deposition disease; ISS, International Staging System; MGUS, monoclonal gammopathy of undetermined significance; MGRS, monoclonal gammopathy of renal significance.
*
serum calcium >0.25 mmol/L (>1 mg/dL) higher than the upper limit of normal or >2.75 mmol/L (>11 mg/dL)
**
Normal range for hemoglobin: Female 11.2–15.5 and males 12.5–16.2