Renal response and safety in real world of bortezomib treatment in newly diagnosed multiple myeloma patients with renal impairment

AIMS: Our objective was to explore the renal efficacy and safety of bortezomib-based treatment in newly diagnosed multiple myeloma (NDMM) patients with Renal impairment (RI). METHODS: We retrospective evaluated NDMM patients with RI at the Second Hospital of Shandong University between between January 2019 and December 2022.RI was defined as having a estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m ² . RESULTS: There were 28 patients inclused, and the mean eGFR was 24.40mL/min/1.73 m ² . All patients received a total of 77 courses of bortezomib-based therapy, and 87.01% regimens were three-drug combinations. The renal responce rates were 67.86%, 76.19%, 75.00%, and 76.92% from the first to forth courses, respectively, and the mean time to achieve renal complete response was 1.33 months.In the moderate reduction in eGFR group, the renal CR rates were 75.00%(6/8), 100.00%(5/5), 100.00%(2/2), and 100.00%(2/2) from the first to forth courses, respectively. In the severe reduction in eGFR group, the renal CR rates were 75.00%(9/12), 62.50%(5/8), 71.43%(5/7), and 66.67%(4/6) from the first to forth courses, respectively. In the renal failure or end-stage renal disease group, the renal CR rates were 50.00%(4/8), 62.50%(5/8), 85.71%(6/7), and 80.00%(4/5) from the first to forth courses, respectively.Median follow-up time of all patients was 14 months.Early death occurred in 5 patients(17.86%). There was no difference in OS between patients in different renal stage. The highest incidence of adverse events was lung infection, followed by neutropenia and thrombocytopenia. CONCLUSIONS:Bortezomib-based regimens had good short-term renal efficacy and safety in the treatment of MM patients with RI.