ALBERT

Description: Background: MGRS is a heterogeneous group of pathologic renal conditions attributed to a clonal plasma cell disorder, without classical features of myeloma. However, there is a need to distinguish MGRS from MGUS and unrelated renal abnormality as the clonal protein in MGRS plays a direct role in kidney damage and requires treatment of the underlying clone. Outcomes in patients with diagnosis of cast nephropathy and renal amyloidosis have been previously reported. But long-term outcomes of MGRS patients with other renal histologies remain unclear. Also data on whether the level of tumour burden in the marrow and type of treatment for MGRS influence long-term outcomes is lacking. This analysis was conducted to study long term outcomes in renal biopsy proven (non cast nephropathy & AL Amyloid) MGRS patients. Aims: This multi-centre retrospective study was set up to analyse clinical outcomes in renal biopsy proven MGRS patients. Long-term haematological and renal outcomes were analysed. Correlation between tumour burden, type of treatment applied and level of response obtained was also analysed. Methods: Thirty-seven MGRS patients were retrospectively audited across 3 centres in the United Kingdom and 1 centre in the Republic of Ireland between 2004 and 2016. Patients were eligible for inclusion if they had a confirmed diagnosis of MGRS by renal biopsy. Patients with cast nephropathy and renal AL Amyloidosis were excluded. Renal survival was defined as the time until renal replacement therapy was required or failure to come off the renal replacement therapy commenced at diagnosis. Overall survival (OS) was calculated from the time of MGRS diagnosis until death from any cause. Results: Median age at diagnosis was 68 years and median follow-up was 33.5 months (range, 0.7-141.7 months). There were 29 male patients and 8 female patients. 20/25 patients had hypertension at the time of diagnosis (records unavailable for 12 patients). Majority of patients were kappa light chain restricted 85% vs 15% lambda LC restricted. Renal histology showed: 65% Light Chain Deposition Disease, 8% Mixed Heavy and Light Chain Deposition Disease, 1 % Proliferative Glomerulonephritis with monoclonal IgG, 11% Light Chain Tubulopathy, 6% Cryoglobulunemia, 3% Immunotactoid Glomerulonephritis. Renal survival for the whole cohort was 74% and overall survival was 84%. At the time of renal biopsy, 43% of patients had 〉10% plasma cells versus 46% of patients with 10% plasma cells versus 70 % in

Description: Background Augustson et al (2005) showed that myeloma patients diagnosed and managed in the early‐mid 2000s are at a higher risk of infections compared to those diagnosed prior to this period. This has been attributed, in part, to a changing treatment paradigm, including the use of proteasome inhibitors (PI) and immunomodulatory drugs (IMiDs) for longer periods which confer different infection risks. Furthermore, infection related outcomes are poorly reported in elderly co-morbid patients due to lack of representation in clinical trials. Assessment of infection related morbidity and mortality in transplant ineligible NDMM patients during routine care requires evaluation, so future strategies can be devised to limit these complications. Methods We performed a single institution retrospective study of 200 transplant ineligible newly diagnosed myeloma patients treated with UK standard of care (2009-2018) to assess infection related outcomes over a 12 month period from treatment initiation. Cumulative incidence of infections at 12 months were compared between the following subgroups using Gray test : age (3 days), of which 2 required ICU admissions. Cumulative 12-month infection-mortality was 4% (95% CI 0.019-0.074). Baseline characteristics did not account for a significant difference in cumulative incidence of all infections and ≥G3 infections except for: elevated LDH, COPD and smoking status (Figure 1A). By MVA, elevated LDH, smoking and number of cycles of therapy (≥6 vs.