대한신장학회

논문분류	춘계학술대회 초록집
제목	Amyloidosis Aggravates Patients’ Survival in Multiple Myeloma
저자	Seon Deok Hwang, Ji Hyun Yu, Woo-yeong Park, Myoung Nam Bae, Byung Ha Chung,Bum Soon Choi, Chul Woo Yang, Yong-Soo Kim, Cheol Whee Park
출판정보	2014; 2014(1):
키워드	유전분증, 다발골수종, 신부전
초록	Background: Renal failure is a common complication of multiple myeloma and other plasma cell dyscrasias. The presence of coexistent kidney disease is considered to be associated with decreased survival rate. The aim of this study is to investigate the effect of presence of amyloidosis and renal failure on the survival rate of plasma cell disorders including multiple myeloma. Methods: 285 patients diagnosed as plasma cell disorders from Dec. 2001 to Feb. 2013 were included in this study, among whom 126 patients (52.9%) comprised of male and the median age and GFR were 57.32±9.563 years and 69.26±33.72 mL/min/1.73m2, respectively. Excluding 47 patients due to missing data, finally enrolled patients accounted for 238 who comprised of amyloid light chain (AL) amyloidosis (n=10), multiple myeloma (MM) with amyloidosis (n=11), MM without amyloidosis (n=212) and the others (n=5). Kaplan Meier survival curve was applied to compare the survival rates among these groups. Result: Between the groups of AL amyloidosis and MM with amyloidosis, no significant difference was found with respect to baseline characteristics including age, sex, transplantation status, Hb, and MDRD-GFR. Kaplan Meier survival curve showed that AL amyloidosis group was associated with superior survival as compare to that of MM with amyloidosis group (p-value: 0.013). The presence of Amyloidosis was associated with inferior survival between MM groups (MM with amyloidosis mortality; 7/11 (63.6%) vs. MM without amyloidosis; 50/212 (23.6%), p<0.001). Moreover, 75 patients with renal failure showed lower survival rate as compared to that of 137 patients with non-renal failure in MM without amyloidosis (non renal failure mortality 25/137 (18.2%) vs. renal failure 25/75(33.3%), p=0.002). Conclusions: In patients with plasma cell disorders, the prognosis of MM with amyloidosis was worse than that of AL amyloidosis and MM without amyloidosis. MM without amyloidosis and AL amyloidosis were not associated with the deterioration of kidney function. However, MM with amyloidosis was associated with decreased kidney function and furthermore, renal failure (GFR<60ml/min) at the time of diagnosis was shown to be an important prognostic factor in relation to its mortality.
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