Therapy of Multiple Myeloma and Myeloma-Related Kidney Disease

Multiple Myeloma (MM) is a clonal expansion of plasma cells. MM is characterized by proliferation of malignant clones producing defective monoclonal immunoglobulins in the bone marrow. MM is the second most common blood cancer following non-Hodgkins lymphoma. It remains an incurable disease with resistance to drugs leading to relapse in most patients even if the treatments for MM have improved over the past decade. Therefore, it is necessary to understand the detailed mechanisms of MM pathogenesis and the drug resistance of MM and develop more effective therapeutic strategies. Current therapies such as Proteasome Inhibitors (PIs), aggresome inhibitors (Histone Deacetylase Inhibitors /HDACi/), Immunomodulatory Drugs (IMiDs) and anti-cell surface glycoprotein CS1, also known as SLAM Family Member 7 (SLAMF7), and CD38 monoclonal antibodies are effective and are followed by an autologous stem cell transplant for patients who are eligible. Myelomarelated End-Stage Renal Disease (ESRD) is not a contraindication for stem cell transplant. Renal insufficiency slightly contributes in transplantation-related mortality (>4% vs 1%). Coordination between the oncologist and nephrologist is important for optimal patient care.