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Role of Plasmapheresis in the Management of Acute Kidney Injury in Patients With Multiple Myeloma: Should We Abandon It?

机译:血浆的作用在多发性骨髓瘤患者急性肾损伤中的作用:我们应该放弃吗?

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摘要

The aim of the current study was to determine whether plasmapheresis in combination with chemotherapy could significantly remove free light chains (FLC) in multiple myeloma (MM) patients with acute kidney injury (AKI) and therefore improve renal recovery and patient survival. During the study period, 29 patients with MM and AKI presented to our unit and were treated with two different therapy modalities (plasmapheresis with chemotherapy or bortezomib). At the end of treatment, a significant decrease of FLCs was present in the group treated with plasmapheresis compared to the bortezomib group. Patients treated with plasmapheresis had similar survival compared to patients treated with bortezomib. There was a significantly higher decrease of FLCs and longer survival in patients treated with three or more plasmapheresis sessions than in patients treated with two plasmapheresis sessions. Plasmapheresis therapy still remains a useful and effective method in the treatment of AKI in MM patients. Plasmapheresis significantly reduces FLCs compared to bortezomib especially with higher number of plasma exchange sessions but it must be combined with other chemotherapy agents in order to prolong renal recovery and therefore patient survival.
机译:目前研究的目的是确定是否与化疗组合的血浆疫苗可显着去除多个骨髓瘤(MM)急性肾损伤(AKI)患者中的自由光链(FLC),从而改善肾脏回收和患者存活。在研究期间,29例MM和AKI患者呈现给我们的单位,并用两种不同的治疗方式(具有化疗或Bortezomib的血浆丸血浆治疗。在治疗结束时,与浆术血管术组在血浆血膜术治疗的基团中存在显着降低的FLC。与用硼齐佐米治疗的患者相比,患有血浆施加的患者具有相似的存活。在用三种或更多种血浆疫苗术治疗的患者中,FLC的减少和较长的生存率显着提高了患者,而不是用两种血浆疫苗术治疗的患者。浆术治疗仍然是治疗MM患者AKI的有用有效的方法。与Bortezomib相比,血浆丸剂显着减少了FLCs,特别是具有较高数量的等离子体交换会话,但必须与其他化疗剂结合以延长肾脏回收并因此患者存活。

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