肾移植术后并发多发性骨髓瘤的诊治进展

doi:10.20047/j.issn1673-7210.2023.19.10

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Abstract Multiple myeloma (MM) is a malignant proliferative disease caused by abnormal hyperplasia of plasma cells in bone marrow. It is characterized by the secretion of monoclonal immunoglobulin and light chain, which can lead to the damage of multiple organs and tissues throughout the body. The kidney is one of the most commonly affected target organs. MM after renal transplantation can cause kidney function impairment in the short term. The mechanism of MM leading to kidney damage is mainly related to the direct toxicity of light chain protein, the deposition of uromodulin, inflammatory reaction fibrosis, and other factors. At present, immunoregulatory drugs and proteasome inhibitors are the main treatment of the disease. Blood purification and autologous hematopoietic stem cell transplantation can also be used. Timely and effective intervention measures are helpful to improve the prognosis. In this paper, the mechanism and diagnosis of kidney injury caused by MM after kidney transplantation is elaborated, the latest clinical strategies and existing problems for the treatment of kidney injury are analyzed, and further research directions are put forward to provide theoretical basis for clinical work.

Key words： Multiple myeloma Kidney transplantation Renal impairment Plasma free light chain

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	PENG Yue LI Jinke ZHOU Jiangqiao

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PENG Yue LI Jinke ZHOU Jiangqiao. Advances in the diagnosis and treatment of multiple myeloma after renal transplantation[J]. 中国医药导报, 2023, 20(19): 49-52.

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https://www.yiyaodaobao.com.cn/EN/10.20047/j.issn1673-7210.2023.19.10 OR https://www.yiyaodaobao.com.cn/EN/Y2023/V20/I19/49

[1] Cowan AJ，Tuazon SA，Portuguese AJ，et al. Chimeric Antigen Receptor T Cells for Multiple Myeloma：The Journey So Far-And the Road Ahead [J]. Cancer J，2021，27（2）：112- 118.
[2] Kane SF. Bone Tumors：Multiple Myeloma [J]. FP Essent，2020，49（3）：30-35.
[3] Andronesi AG，Tanase AD，Sorohan BM，et al. Incidence and risk factors for acute kidney injury following autologous stem cell transplantation for multiple myeloma [J]. Cancer Med，2019，8（6）：3278-3285.
[4] Ry?觢avá R. Renal failure in multiple myeloma and its treatment [J]. Vnitr Lek，2020，66（7）：425-431.
[5] 吕佳，贺扬欣，王锦程，等.多发性骨髓瘤伴肾损害患者肾脏病理及细胞遗传学检查的回顾性分析[J].中国实验血液学杂志，2020，28（4）：1272-1277.
[6] 黄昭萍，杨灿华.老年多发性骨髓瘤合并肾损伤患者的病理特征及危险因素分析[J].中国医药，2021，16（3）：417-421.
[7] 朱国庆，付雪，任彦松，等.不同血清游离轻链检测系统在多发性骨髓瘤疾病诊断中的比较分析[J].中国实验血液学杂志，2021，29（4）：1209-1215.
[8] 胡玉皎，郝晓柯，程晓东，等.免疫固定电泳联合游离轻链检测对多发性骨髓瘤的诊断价值[J].检验医学与临床，2020，17（21）：3077-3079.
[9] Pawlyn C，Davies FE. Toward personalized treatment in multiple myeloma based on molecular characteristics [J]. Blood，2019，133（7）：660-675.
[10] Finkel KW，Cohen EP，Shirali A，et al. Paraprotein-Related Kidney Disease：Evaluation and Treatment of Myeloma Cast Nephropathy [J]. Clin J Am Soc Nephrol，2016：2273- 2279.
[11] Owoyemi I，Sethi S，Leung N. Kidney Injury in Multiple Myeloma：A Kidney Biopsy Teaching Case [J]. Kidney Med，2021，3（12）：303-306.
[12] Finkel KW，Cohen EP，Shirali A，et al. American Society of Nephrology Onco-Nephrology Forum. Paraprotein-Related Kidney Disease：Evaluation and Treatment of Myeloma Cast Nephropathy [J]. Clin J Am Soc Nephrol，2016，11（12）：2273-2279.
[13] 毛永辉，王松岚.多发性骨髓瘤肾损害的诊疗进展[J].中华肾病研究电子杂志，2017，6（5）：195-199.
[14] Dimopoulos MA，Jakubowiak AJ，McCarthy PL，et al. Developments in continuous therapy and maintenance treatment approaches for patients with newly diagnosed multiple myeloma [J]. Blood Cancer J，2020，10（2）：17.
[15] Durie BG，Hoering A，Abidi MH，et al. Bortezomib with lenalidomide and dexamethasone versus lenalidomide and dexamethasone alone in patients with newly diagnosed myeloma without intent for immediate autologous stem-cell transplant（SWOG S0777）：a randomised，open-label，phase 3 trial [J]. Lancet，2017，389（10068）：519-527.
[16] Rosinol L，Oriol A，Teruel AI，et al. Superiority of bortezomib，thalidomide，and dexamethasone（VTD）as induction pretransplantation therapy in multiple myeloma：a randomized phase 3 PETHEMA/GEM study [J]. Blood，2012，120（8）：1589-1596.
[17] Cavo M，Tacchetti P，Patriarca F，et al. Bortezomib with tha- lidomide plus dexamethasone compared with thalidomide plus dexamethasone as induction therapy before，and consolidation therapy after，double autologous stem-cell transplantation in newly diagnosed multiple myeloma：a randomised phase 3 study [J]. Lancet，2010，376（9758）：2075- 2085.
[18] Moreau P，Dimopoulos MA，Mikhael J，et al. IKEMA study group．Isatuximab，carfilzomib，and dexamethasone in relapsed multiple myeloma（IKEMA）：a multicentre，open-label，randomised phase 3 trial [J]. Lancet，2021，397（10292）： 2361-2371.
[19] 中华医学会血液学分会浆细胞疾病学组，中国医师协会多发性骨髓瘤专业委员会.中国多发性骨髓瘤自体造血干细胞移植指南（2021年版）[J].中华血液学杂志，2021， 42（5）：353-357.
[20] Wang X，Walter M，Urak R，et al. Lenalidomide Enhances the Function of CS1 Chimeric Antigen Receptor-Redirected T Cells Against Multiple Myeloma [J]. Clin Cancer Res，2018，24（1）：106-119.
[21] Qu J，Mei Q，Chen L，et al. Chimeric antigen receptor（CAR）-T cell therapy in non-small-cell lungcancer（NSCLC）：current status and future perspectives [J]. Cancer Immunol Immunother，2021，70（3）：619-631.
[22] Samur MK，Fulciniti M，Aktas Samur A，et al. Biallelic loss of BCMA as a resistance mechanism to CAR T cell therapy in a patient with multiple myeloma [J]. Nat Commun，2021，12（1）：868-870.
[23] Hillengass J，Usmani S，Rajkumar SV，et al. International myeloma working group consensus recommendations on imaging in monoclonal plasma cell disorders [J]. Lancet Oncol，2019，20（6）：e302-e312.
[24] Raje N，Berdeja J，Lin Y，et al. Anti-BCMA CAR T-Cell Therapy bb2121 in Relapsed or Refractory Multiple Myeloma [J]. N Engl J Med，2019，380（18）：1726-1737.
[25] Tiranathanagul K，Khemnark N，Takkavatakarn K，et al. Comparative efficacy between hemodialysis using super high-flux dialyzer with hemoperfusion and high-volume postdilution online hemodiafiltration in removing protein bound and middle molecule uremic toxins：A cross-over randomized controlled trial [J]. Artif Organs，2022，46（5）：775-785.
[26] Yang J，Ke G，Liao Y，et al. Efficacy of medium cut-off dialyzers and comparison with high-flux dialyzers in patients on maintenance hemodialysis：A systematic review and meta- analysis [J]. Ther Apher Dial，2022，26（4）：756-768.
[27] 柯小苏，李玉微，骆丽霞.高剂量分段枸橼酸对高通量血液透析抗凝效果临床观察[J].临床肾脏病杂志，2021， 21（8）：677-680.
[28] 潘明明，谢筱彤，高民，等.血液滤过吸附再回输在维持性血液透析患者中的应用疗效研究[J].中国血液净化，2021，20（10）：674-675.
[29] Caponi L，Romiti N，Koni E，et al. Inter-assay variability in automated serum free light chain assays and their use in the clinical laboratory [J]. Crit Rev Clin Lab Sci，2020，57（2）：73-85.
[30] Heybeli C，Bentall AJ，Alexander MP，et al. Kidney Transplant Outcomes of Patients With Multiple Myeloma [J]. Kidney Int Rep，2022，7（4）：752-762.
[31] Le TX，Wolf JL，Peralta CA，et al. Kidney Transplantation for Kidney Failure Due to Multiple Myeloma：Case Reports [J]. Am J Kidney Dis，2017，69（6）：858-862.