Is there still a role for plasma exchange/PLEX for confirmed or suspected cast nephropathy in multiple myeloma to rapidly reduce light chain burden?

Topics: Hematologic Malignancies • Medical Oncology • Myeloma • NCI-CCC Tumor Board Question • University of Washington • NCI-CCC Myeloma Tumor Board Question • Multiple Myeloma

In addition to reversing hypercalcemia, initiating myeloma therapy, etc.

Answer from: Medical Oncologist at Academic Institution

This is a good question that comes up from time to time. The most important thing is time-to-bortezomib, which should be as short as possible.For light chain only disease, I do not do plasma exchange. My reasons are: It only marginally reduces free light chains (see: Hutchison et al., PMID 17229909...

Comments

Medical Oncologist at University of Washington, Fred Hutchinson Cancer Research Center
Amazingly helpful - thank you, @Ben! Ironically, c...

Medical Oncologist at Winship Cancer Institute of Emory University
I think that these patients with cast nephropathy ...

Medical Oncologist at University of Washington, Fred Hutchinson Cancer Research Center
Yes indeed - I 100% agree with @Craig C. Hofmeiste...

Medical Oncologist at Clinical Instructor
For readers interested, we had another discussion ...

Medical Oncologist at University of Washington, Fred Hutchinson Cancer Research Center
This is great, and I agree quite germane to this d...

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