文章：

卡非佐米相关肾毒性常见且不可预测：对114例多发性骨髓瘤患者的综合分析

Carfilzomib-associated renal toxicity is common and unpredictable: a comprehensive analysis of 114 multiple myeloma patients

原文发布日期：2020-11-03

DOI: 10.1038/s41408-020-00381-4

类型: Article

开放获取: 是

英文摘要：

Carfilzomib (CFZ) is a non-reversible proteasome inhibitor approved for the treatment of patients with relapsed and refractory myeloma (RRMM). Its use has been associated with cardiovascular toxicity but although recently a signal of clinically significant renal complications has also been identified, it is less extensively investigated. We analyzed data of 114 consecutive patients with RRMM who received CFZ-based regimens. Renal complications not related to MM progression were observed in 19 (17%) patients; thrombotic microangiopathy (TMA) was seen in 6 (5%) patients, albuminuria >1 gr/day in 7 patients (6%) and at least grade 3 acute kidney injury (AKI) which could not be otherwise explained in 6 patients (5%). A total of 15 patients discontinued CFZ and dosing was reinitiated at a lower level in one patient with AKI. Albuminuria was associated with focal segmental glomerulosclerosis in the renal biopsy (performed in a total of 6 patients). Renal complications during CFZ therapy are common, occur mostly early and are unpredictable. A potential effect of CFZ on the renal endothelium could be implicated in the pathogenesis of these complications and may also share common pathophysiology with cardiovascular effects of CFZ.
 

摘要翻译： 

卡非佐米(CFZ)是一种不可逆蛋白酶体抑制剂，已被批准用于治疗复发难治性多发性骨髓瘤(RRMM)患者。其应用与心血管毒性相关，但尽管近期亦发现具有临床显著性的肾脏并发症信号，该领域的研究尚不充分。我们分析了114例接受CFZ为基础方案治疗的RRMM连续患者数据。19例(17%)患者出现与MM进展无关的肾脏并发症；其中6例(5%)发生血栓性微血管病(TMA)，7例(6%)出现蛋白尿>1克/日，6例(5%)发生无法用其他原因解释的至少3级急性肾损伤(AKI)。共15例患者停用CFZ，1例AKI患者以较低剂量重新给药。肾活检（共6例患者执行）显示蛋白尿与局灶节段性肾小球硬化相关。CFZ治疗期间的肾脏并发症常见，多早期发生且不可预测。CFZ对肾脏内皮的潜在影响可能参与这些并发症的发病机制，或许与CFZ心血管效应存在共同病理生理基础。

原文链接：

Carfilzomib-associated renal toxicity is common and unpredictable: a comprehensive analysis of 114 multiple myeloma patients