Teaching points
- Less than 3% of patients younger than 40 are diagnosed with MM
- T(14;16) translocation is considered high risk with a poor prognosis. It is associated with isotype Lambda and kidney failure as a predominant MM-defining event
- TP53 deletion is associated with a poor outcome whereas its amplification has a good outcome
- Kidney biopsy is useful in selected cases only and can play the role of a diagnostic and prognostic tool
- Cast nephropathy is the most common lesion seen on biopsy
- Removal of FLCs by high cutoff hemodialysis may be used as an adjunctive therapy. However, trials on HCO-HD were of small size with different methodologies and their use remains controversial