The International Myeloma Working Group (IMWG) has updated its recommendations for the diagnosis and management of myeloma-related renal impairment. According to the new document, a renal assessment should be performed at diagnosis and at every follow-up due to the worse prognosis of multiple myeloma when renal impairment is involved.
The authors of the guidelines, which were published in the Journal of Clinical Oncology, also acknowledge that this effect on prognosis persists even when the renal impairment is reversed. IMWG defines renal impairment in symptomatic myeloma as elevated serum creatinine (>2 mg/dL) or reduced creatinine clearance (CrCl; 15 mL/min, and ixazomib can be used in combination with lenalidomide and dexamethasone in those with CrCl >30 mL/min. The recommendation did not comment on recently approved monoclonal antibodies (daratumumab and elotuzumab).
Source: Dimopoulos MA, Sonneveld P, Leung N, et al. International Myeloma Working Group recommendations for the diagnosis and management of myeloma-related renal impairment. J Clin Oncol. 2016 March 14. [Epub ahead of print]