Mayo Clinic Laboratory and Pathology Research Roundup: March 16
The research roundup provides an overview of the past week’s research from Mayo Clinic Laboratories consultants, including featured abstracts and a complete list of published studies and reviews.
Clinicopathologic Predictors of Renal Outcomes in Light Chain Cast Nephropathy: A Multicenter Retrospective Study.
Light chain cast nephropathy (LCCN) in multiple myeloma often leads to severe and poorly reversible acute kidney injury. Severe renal impairment influences the allocation of chemotherapy, its tolerability, and affects patient survival. Whether renal biopsy findings add to the clinical assessment in predicting renal and patient outcomes in LCCN is uncertain. We retrospectively reviewed clinical presentation, chemotherapy regimens, hematologic response, renal and patient outcomes in 178 patients with biopsy-proven LCCN from 10 centers in Europe and North America. A detailed pathology review, including assessment of the extent of cast formation, was performed to study correlations with initial presentation and outcomes. Patients presented with mean eGFR of 13±11 mL/min/1.73m2, and 82% had stage 3 acute kidney injury. The mean number of casts was 3.2/mm2 in the cortex. Tubulointerstitial lesions were frequent: acute tubular injury (94%), tubulitis (82%), tubular rupture (62%), giant cell reaction (60%), cortical and medullary inflammation (95 and 75%). Medullary inflammation, giant cell reaction and the extent of cast formation correlated with eGFR value at LCCN diagnosis. During a median follow-up of 22 months, mean eGFR increased to 43±30 mL/min/1.73m2. Age, β2-microglobulin, best hematologic response, number of cortical casts/mm2 and degree of interstitial fibrosis/tubular atrophy (IFTA) were independently associated with a higher eGFR during follow-up. This eGFR value correlated with overall survival, independently of the hematologic response. This study shows that extent of cast formation and IFTA in LCCN predicts the quality of renal response which, in turn, is associated with overall survival. Via Blood.
Published to PubMed This Week
- The Gloomy Long-Term Prognosis of Patients With Type 2 Myocardial Infarction or Myocardial Injury.
Journal of the American College of Cardiology
- Targeting of Inflammatory Pathways with R2CHOP in High-Risk DLBCL.
- Quality of Life in Heart Failure with Preserved Ejection Fraction: Importance of Obesity, Functional Capacity, and Physical Inactivity.
European Journal of Heart Failure
- Fumarate Hydratase-Deficient Renal Cell Carcinoma.
Mayo Clinic Proceedings
- Current Management and Treatment Options for Breast Pain.
Mayo Clinic Proceedings
- KRAS Mutations in Papillary Fibroelastomas: A Study of 50 Cases With Etiologic and Diagnostic Implications.
American Journal of Surgical Pathology
- Genotype and Phenotype Concordance for Pharmacogenetic Tests Through Proficiency Survey Testing: An Update.
Archives of Pathology and Laboratory Medicine
- Emergent Thrombocytapheresis for Essential Thrombocythemia Following Splenectomy.
- Perioperative Outcomes of Total Vaginal Hysterectomy in Women with Prior Cesarean Delivery.
Journal of Minimal Invasive Gynecology
- Defining Acute Myeloid Leukemia Ontogeny in Older Patients.
Clinical Lymphoma, Myeloma, and Leukemia