Authors
Christina I Shincovich, Api Chewcharat, Motohiko Adomi, Emma E McGee, Raphael Kim, Marta Pirovano, Jason Prosek, Srinivas S Devarakonda, Joshua Leisring, Eshetu Obole, Jasmin Tharakan, Arti Vaishnav, Nattawat Klomjit, Pornlada Likasitwatanakul, Chester Andrzejewski, Sajjad Hassan, Annie Elizabeth Abraham, Lynne O'Hearn, Oscar Garcia Valencia, Jennifer S McDonald, M Salman Sheikh, Boyoung Michelle Kim, Priscilla Koirala, A Bilal Malik, Anip Bansal, Blaithin A McMahon, Benjamin Teruel, Jaya Kala, Abdallah Geara, Kristen Tillquist, Swetha Kanduri, Raphael Szalat, Ali Aijaz, Omar Mamlouk, Susan L Ziolkowski, Jillian Caldwell, Marco Bonilla, Nader Ismail, Pooja D Amarapurkar, Joseph K Franz, Rasheed A Balogun, Eibhlin Goggins, Claude Bassil, Shrinjaya Thapa, Rachid Baz, Daniel Sanghoon Shin, Jonathan E Zuckerman, Kanwarpal Kahlon, Yesha Shah, Kenar D Jhaveri, Richa Thakur, Jingjing Zhang, Priya Deshpande, Matthew H Abramson, Dureya Syed, Arun Rajasekaran, Ashwini Pujari, Jay S Raval, Linette Bosques, Florence H Porterfield, Eashwar V Somasundaram, Sophia L Wells, Mia B Rubman, Robert Seitter Pérez, Alexa C Peterkin, Carolina Saldanha Neves Horta Lima, Naoka Murakami, Maho Terashita, E Bridget Kim, Kareem Mosaheb, Paul E Hanna, Omar Nadeem, David E Leaf, Raad B Chowdhury, Sean R Stowell, Andrew J Yee, Nelson Leung, Shruti Gupta
Published in
American journal of hematology. Oct 12, 2026. Epub Oct 12, 2026.
Abstract
Multiple myeloma light chain cast nephropathy (LCCN) is often treated with plasma exchange (PLEX) or the anti-CD38 monoclonal antibody, daratumumab. However, rigorous studies supporting these therapies for LCCN are limited. Using data from 25 U.S.-based academic cancer centers, we conducted two target trials examining the association between early receipt of PLEX or early receipt of daratumumab and kidney recovery in patients with newly diagnosed LCCN. Kidney recovery was defined as being alive, not on kidney replacement therapy, and with an improvement of at least one stage of AKI severity, all assessed at 90 days. Secondary outcomes included kidney recovery at 60 and 180 days. Logistic regression with propensity score overlap weights was used to adjust for confounders. Of 549 eligible patients for the PLEX target trial, 158 (28.8%) received PLEX. There was no association between PLEX and kidney recovery at 90 days (OR 1.48, 95% CI: 0.96-2.30). However, in subgroup analyses, PLEX was associated with higher odds of kidney recovery at 90 days among patients with newly diagnosed multiple myeloma compared to those with relapsed disease, as well as higher odds of kidney recovery among those with Stage 3 versus Stage 1 or 2 AKI at the time of LCCN diagnosis. Of 474 patients eligible for the daratumumab target trial, 136 (28.7%) received daratumumab. Daratumumab was not associated with kidney recovery at 90 days (OR 1.46, 95% CI: 0.84-2.55). Thus, in this multicenter cohort study, neither PLEX nor daratumumab was associated with kidney recovery at 90 days.
PMID:
42864738
Bibliographic data and abstract were imported from PubMed on 13 Oct 2026.
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