Table 3.
Published studies of use of HCO haemodialysis in myeloma patients with severe RI
| Study | Year | Patients on RRT | Disease status | Renal biopsy findings | Chemotherapy | Myeloma response | Renal response |
|---|---|---|---|---|---|---|---|
| Hutchison et al. [121] | 2007 | 5 | de novo | MCN | dexamethasone-based regimen | not reported | 3 (60%) achieved dialysis independence |
| Hutchison et al. [30] | 2009 | 19 | 16 patients – de novo 3 patients – relapsed | MCN | cyclophosphamide - 7; thalidomide - 14; vincristine + doxorubicin - 1; dexamethasone – all patients | not reported; however, sustained FLC reduction noted in 13 (68.4%) patients | 14 (73.6%) patients achieved dialysis independence |
| Peters et al. [140] | 2011 | 5 | de novo | MCN | VD | not reported; however, a mean FLC reduction of 90 ±6% seen after the third session of HCO dialysis, with an FLC reduction of 61 ± 20% per session over 2 weeks | 3 (60%) patients became dialysis independent |
| Sinisalo et al. [125] | 2012 | 7 | de novo | available in 6 (85.7%) patients, all demonstrating MCN | VD - 3; VD + MP - 1; VD + VADa - 1; RVD - 1; VTD - 1 | not reported | 6 (85.7%) patients achieved dialysis independence |
| Hutchison et al. [39] | 2012 | 67 | 50 patients – de novo 17 patients – relapsed | available in 38 (56.7%) patients with 86.7% demonstrating MCN | novel agent used in 56 patients | 42 (61%) patients had a reduction in FLC levels; amongst these, 83% had a ≥50% decline in FLC levels by day 21 | 42 (63%) patients achieved dialysis independence |
| Heyne et al. [127] | 2012 | 19 | 10 patients – de novo 9 patients – relapsed or refractory | available in 6 (31.5%) patients, all demonstrating MCN | novel agent used in 14 patients | ≥PR - 6 (42.8%) | 14 (73.7%) patients achieved dialysis independence |
| Khalahfallah et al. [124] | 2013 | 4 | 3 patients – de novo 1 patient – relapsed | unknown if renal biopsy performed | VAD - 2; VD - 1 TD - 1 (switched to RD) | ≥VGPR - 3 (75%) patients | 3 (75%) patients achieved dialysis independence |
| Tan et al. [141] | 2014 | 6 | de novo | MCN | VCD - 3; CTD - 1; CD - 2 | ≥PR - 4 (66.6%) | 3 (50%) patients achieved dialysis independence |
| Zanetti et al. [122] | 2015 | 21 | de novo | 15 (71.4%) patients demonstrating MCN | VTD - 13 (ASCT eligible) VMP - 8 (ASCT ineligible) | sCR - 4 (19%), VGPR - 10 (48%), and PR - 3 (14%) | 16 (76%) patients achieved dialysis independence |
RRT = Renal replacement therapy; PRrenal = partial renal response; MRrenal = minor renal response; VD = bortezomib and dexamethasone; MP = melphalan and prednisolone; VADa = vincristine, adriamycin and dexamethasone; RVD = lenalidomide, bortezomib and dexamethasone; VTD = bortezomib, thalidomide and dexamethasone; VAD = bortezomib, adriamycin and dexamethasone; TD = thalidomide and dexamethasone; RD = lenalidomide and dexamethasone; CD = cyclophosphamide and dexamethasone; VCD = bortezomib, cyclophosphamide and dexamethasone; CTD = cyclophosphamide, thalidomide and dexamethasone; VMP = bortezomib, melphalan and prednisolone; sCR = stringent complete response.