Terapevticheskii arkhivTerapevticheskii arkhiv0040-36602309-5342LLC Obyedinennaya Redaktsiya3361210.26442/00403660.2019.07.000215Research ArticleDifficulties evaluating hematological response in patients with multiple myeloma and dialysis - dependent renal impairmentRekhtinaI Grekhtina.i@blood.ruMendeleevaL P-SobolevaN P-National Research Center for Hematology15072019917707416042020Copyright © 2019, Consilium Medicum2019Aim: to determine serum free light chains (FLC) level by patients with multiple myeloma (MM) and dialysis - dependent renal impairment in which the amount Bence Jones (BJ) protein in the urine met the criteria of hematological response. Patients and methods: This study included 13 MM with dialysis - dependent renal impairment patients (estimated glomerular filtration rate < 10 ml/min), whose urine BJ protein content was less than 200 mg/day after antimyeloma therapy (including 11 patients whose urine BJ protein content was less than 100 mg/day). Results. The median serum concentration of monoclonal FLC was 608.7 (298-8380) mg/l. Thus, with trace amounts BJ protein in the urine serum content monoclonal FLC varied 28 times with the same degree of severity of renal failure. In patients with oliguria serum SLC content was significantly higher than in normal diuresis (1109 and 307 mg/L; p<0.05). Conclusion. Low amount of BJ protein in urine of patients with MM and dialysis - dependent renal impairment can be combined with high concentration of monoclonal FLC in serum. Therefore, the study of FLC in serum is necessary for monitoring MM in this group of patients. It is important to develop clarifying criteria of hematological response in patients with MM and dialysis - dependent renal impairment.multiple myelomaserum free light chain leveldialysis - dependent renal impairmenthematological responseмножественная миеломадиализзависимая почечная недостаточностьсвободные легкие цепигематологический ответ[Dispenzieri A, Kyle R, Merlini G, Miguel J.S, Ludwig H, Hajek R, Palumbo A, Jagannath S, Blade J, Lonial S, Dimopoulos M, Comenzo R, Einsele H, Barlogie B, Anderson K, Gertz M, Harousseau J.L, Attal M, Tosi P, Sonneveld P, Boccadoro M, Morgan G, Richardson P, Sezer O, Mateos M.V, Cavo M, Joshua D, Turesson I, Chen W, Shimizu K, Powles R, Rajkumar S.V, Durie B.G.M. International Myeloma Working Group guidelines for serum - free light chain analysis in multiple myeloma and related disorders. Leukemia. 2008;1-10. doi: 10.1038/leu.2008.307][Bradwell A.R. Serum free light chain analysis plus hevylite. 7th ed. UK (Birmingham): The Binding Site Group, 2015.][Kumar S, Paiva B, Anderson K.C, Durie B, Landgren O, Moreau P, Munshi N, Lonial S, Bladé J, Mateos M.V, Dimopoulos M, Kastritis E, Boccadoro M, Orlowski R, Goldschmidt H, Spencer A, Hou J, Chng W.J, Usmani S.Z, Zamagni E, Shimizu K, Jagannath S, Johnsen H.E, Terpos E, Reiman A, Kyle R.A, Sonneveld P, Richardson P.G, Mc Carthy P, Ludwig H, Chen W, Cavo M, Harousseau J.L, Lentzsch S, Hillengass J, Palumbo A, Orfao A, Rajkumar S.V, Miguel J.S, Avet-Loiseau H. International Myeloma Working Group consensus criteria for response and minimal residual disease assessment in multiple myeloma. Lancet Oncol. 2016;17:e328-46. doi: 10.1016/S1470-2045(16)30206-6][Dimopoulos M, Sonneveld P, Leung N, Merlini G, Ludwig H, Kastritis E, Goldschmidt H, Joshua D, Orlowski R, Powles R, Vesole D, Garderet L, Einsele H, Palumbo A, Cavo M, Richardson P, Moreau P, San Miguel J, Rajkumar S, Durie B, Terpos E. International Myeloma Working Group recommendations for the diagnosis and management of myeloma - related renal impairment. J Clin Oncol. 2016;34:1544-57. doi: 10.1200/JCO.2015.65][Moreau P, San Miguel J, Sonneveld P, Mateos M.V, Zamagni E, Avet-Loiseau H, Hajek R, Dimopoulos M.A, Ludwig H, Einsele H, Zweegman S, Facon T, Cavo M, Terpos E, Goldschmidt H, Attal M, Buske C. ESMO Guidelines Committee. Multiple myeloma: ESMO Clinical Practice Guidelinesfor diagnosis, treatment and follow - up. Ann Oncol. 2017;28(suppl 4):iv52-iv61. doi: 10.1093/annonc/ mdx096]