Study On The Effect Of Different Chemotherapy Regimens On Renal Function In Multiple Myeloma

Background and objective: Multiple myeloma(MM)is a group of malignant clonal diseases originating from plasma cells.The pathogenesis of MM is not clear at present,and the treatment effect is not very satisfactory.The survival time of patients with renal dysfunction and the quality of life is greatly reduced.Chemotherapy is the main means of MM,but there is no uniform standard for the choice of chemotherapy.The proteasome inhibitor Bortezomib is of great significance in the treatment of MM.This study evalute the most sensitive and specific indicator by analyzing the renal data of MM patients before and after chemotherapy.At the same time,study the effects of different chemotherapy regimens on the MM patients with renal function,discusses the MM treatment scheme selection,so as to provide certain ideas for the treatment of MM.Methods: Collecting 117 cases of multiple myeloma patients confirmed at our department of Hematology(2015.01-2018.01).To evalute the most sensitive and specific indicator among serum cystatin C,serum creatinine and blood urea nitrogen.At the same time,according to the different treatment regimens,the patients were divided into Bortezomib group and Non-bortezomib group regimen group.The changes of renal function before and after four cycles in each group were observed.Results: 1.The level of Serum cystatin C,serum creatinine and blood urea nitrogen in abnormal renal function group was obviously higher than that of normal renal function and the normal control group among the totle 117 cases of multiple myeloma patients before treated,the difference is statistically significant(P < 0.05).2.Serum cystatin C,Scr and BUN have a significant correlation with glomerular filtration rate(all P <0.01);Serum cystatin C has the largest area under the ROC curve and the smallest BUN.3.Serum cystatin C levels were different among MM patients with different CKD stages,and the difference was statistically significant(P <0.01).4.There was no statistically significant difference in Serum cystatin C levels between ISS stageⅠand stage II(P> 0.05).Serum cystatin C levels in stage III were higher than those in stagesⅠand Ⅱ.and the difference was statistically significant(P <0.05).5.There was no statistically significant difference in serum Cys-C levels among different immunoglobulin types,genders,and age groups in MM patients(P> 0.05).6.The level of serum Cys-C decreased after chemotherapy in both groups,and the level of serum Cys-C in the Bortezomib group decreased more than that in the Non-bortezomib group(P <0.05).Conclusion:1.Serum Cys-C has a good correlation with glomerular filtration rate and is an ideal indicator for monitoring renal function.2.Serum Cys-C is related to ISS stage and CKD stage,but not to age,gender and immunoglobulin types.3.For newly treated MM patients,the three chemotherapy regimens of PAD、VAD and DVD can all improve the renal function of MM patients.The Bortezomib group containing bortezomib is superior to the Non-bortezomib group without bortezomib in reversing renal function.