PMID- 21479696
OWN - NLM
STAT- MEDLINE
DCOM- 20120918
LR  - 20211020
IS  - 1559-131X (Electronic)
IS  - 1357-0560 (Linking)
VI  - 29
IP  - 2
DP  - 2012 Jun
TI  - Bortezomib-based chemotherapy for light chain deposition disease presenting as 
      acute renal failure.
PG  - 1197-201
LID - 10.1007/s12032-011-9938-4 [doi]
AB  - We report a case of kappa light chain deposition disease (LCDD) associated with 
      multiple myeloma in a patient presenting with acute renal failure, 2+ proteinuria 
      and hypercalcemia. Serum protein electrophoresis showed an M-spike at 0.1 g/dL. 
      24-h urine protein electrophoresis showed Bence-Jones proteinuria of 3.8 g. 
      Serum-free light chain assay found excess kappa chains at 3080 mg/L, with normal 
      lambda and an elevated kappa:lambda ratio of 124.7. A kidney biopsy revealed 
      kappa light chain nephropathy with PAS-negative tubular casts in the cortex and 
      outer medulla. Bone marrow biopsy showed 15% kappa-restricted plasma cells. Serum 
      beta-2 microglobulin level was elevated at 7.94 mg/dL. The patient received a 
      3-day course of plasmapheresis followed by eight cycles of bortezomib (Velcade(R)), 
      liposomal doxorubicin, and dexamethasone (VDD) and did not require hemodialysis. 
      As partial response was not achieved, treatment was continued with three cycles 
      of bortezomib, cyclophosphamide, dexamethasone, and thalidomide, followed by 
      thalidomide maintenance at 100 mg daily. Thirty-two months after the diagnosis, 
      the patient's renal function was improved and he achieved a partial response. 
      This case underlines the feasibility and effectiveness of bortezomib-based 
      chemotherapy in the treatment of LCDD with severe renal dysfunction.
FAU - Gharwan, Helen
AU  - Gharwan H
AD  - Johns Hopkins University/Sinai Hospital Program of Internal Medicine, Baltimore, 
      MD, USA.
FAU - Truica, Cristina I
AU  - Truica CI
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20110409
PL  - United States
TA  - Med Oncol
JT  - Medical oncology (Northwood, London, England)
JID - 9435512
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Boronic Acids)
RN  - 0 (Immunoglobulin kappa-Chains)
RN  - 0 (Pyrazines)
RN  - 69G8BD63PP (Bortezomib)
SB  - IM
MH  - Acute Kidney Injury/complications/*diagnosis/*drug therapy
MH  - Antineoplastic Agents/*therapeutic use
MH  - Boronic Acids/*therapeutic use
MH  - Bortezomib
MH  - Diagnosis, Differential
MH  - Humans
MH  - Immunoglobulin kappa-Chains/*metabolism
MH  - Male
MH  - Middle Aged
MH  - Multiple Myeloma/complications/*diagnosis/*drug therapy
MH  - Prognosis
MH  - Pyrazines/*therapeutic use
MH  - Remission Induction
EDAT- 2011/04/12 06:00
MHDA- 2012/09/19 06:00
CRDT- 2011/04/12 06:00
PHST- 2011/03/22 00:00 [received]
PHST- 2011/03/28 00:00 [accepted]
PHST- 2011/04/12 06:00 [entrez]
PHST- 2011/04/12 06:00 [pubmed]
PHST- 2012/09/19 06:00 [medline]
AID - 10.1007/s12032-011-9938-4 [doi]
PST - ppublish
SO  - Med Oncol. 2012 Jun;29(2):1197-201. doi: 10.1007/s12032-011-9938-4. Epub 2011 Apr 
      9.