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Myeloma Cisplatin- Kidney Damage?
I’m going to go out on a limb and say that myeloma patients risk kidney damage and therefore risk cisplatin-induced kidney damage. Meaning, if you are diagnosed with multiple myeloma you are at a high-risk of having your MM damage your kidney function. Cisplatin may make things worse…
In my experience as both a myeloma patient and myeloma cancer coach, oncologists focus on the patient’s monoclonal proteins. This is to be expected. Unfortunately, many MM patients end up dying from kidney failure, not myeloma. I think MM and kidney health must be managed equally for those MM patients who indicate that their kidney health has been affected.
When I read the phrase “some amount of kidney failure” I picture tiny myeloma proteins gumming up the patient’s kidneys. The “gumming up” of the kidney may not result in a full diagnosis of total kidney failure. Your
- creatinine
- BUN
- eGFR
may only only slightly above or below the normal range for this diagnostic finding. This may not sound very technical but I think it can happen to MM patients.
If you then undergo cisplatin, I can’t help but believe that the patient is damaging their kidney function further.
What are possible short and long-term side effects of cisplatin?
Short-term side effects:
- Nausea and vomiting: These are common side effects, usually occurring shortly after treatment. Medications can help manage these symptoms.
- Hair loss: Cisplatin can cause temporary hair loss, including scalp, body, and facial hair.
- Fatigue: Feeling tired or lacking energy is common during chemotherapy.
- Decreased appetite: Some people experience a loss of appetite or changes in taste during treatment.
- Low blood cell counts: Cisplatin can suppress the bone marrow, leading to low counts of white blood cells (increasing the risk of infection), red blood cells (causing anemia), and platelets (increasing the risk of bleeding).
- Kidney toxicity: Cisplatin can damage the kidneys, leading to decreased kidney function and potentially acute kidney injury.
- Nerve damage (neuropathy): Cisplatin can cause tingling, numbness, or pain in the hands and feet, known as peripheral neuropathy.
- Hearing loss: Cisplatin can cause damage to the inner ear, leading to hearing loss or ringing in the ears (tinnitus).
- Allergic reactions: Some people may experience allergic reactions to cisplatin, though this is less common.
Long-term side effects:
- Kidney damage: Chronic kidney problems can occur even after the completion of treatment.
- Nerve damage (neuropathy): Peripheral neuropathy can persist or worsen over time, affecting daily activities and quality of life.
- Hearing loss: Cisplatin-induced hearing loss may continue or worsen after treatment.
- Secondary cancers: There is a risk of developing secondary cancers, particularly in the long term.
- Heart problems: Some studies suggest an increased risk of cardiovascular issues, such as heart attacks or heart failure, in patients treated with cisplatin.
- Infertility: Cisplatin can affect fertility, particularly in men, leading to reduced sperm count or infertility.
- Emotional and psychological effects: Coping with the physical and emotional challenges of cancer treatment can lead to anxiety, depression, or other mental health issues.
Cisplatin is a chemo regimens that has been approved by the FDA as being “safe and effective.”
The key thing for myeloma patients to remember is that there is a long and growing list of chemotherapy regimens shown to treat MM. If you have any amount of kidney failure, please question your oncologist if he/she even utters the word cisplatin.
Are you newly diagnosed with multiple myeloma? What stage? What symptoms? Are you relapsed/refractory MM? What is the most recent reading of your kidney markers?
If you would like to learn more about evidence-based therapies shown to enhance kidney function please click the link and send me an email. I will reply to you ASAP. David.PeopleBeatingCancer@gmail.com
Thank you,
David Emerson
- Long-term MM Survivor
- MM Cancer Coach
- Director PeopleBeatingCancer
Innovative tool could safeguard cancer patients from chemotherapy-induced kidney damage
“Using patient data from six major U.S. cancer centers, Brigham researchers and collaborators developed a risk prediction model for moderate-to-severe kidney injury after receiving the chemotherapy drug cisplatin in the largest, first generalizable study of its kind…
…researchers…developed a comprehensive tool to predict which patients are at highest risk of moderate-to-severe kidney injury after cisplatin. They found that the highest-risk patients had as much as a 20-fold higher risk of developing kidney injury after cisplatin than those in the lowest-risk group.
The researchers examined data from over 24,000 patients across six major U.S. cancer centers… and analyzed the risk of moderate-to-severe acute kidney injury within the first 14 days following a single, first IV dose of cisplatin. The model developed by the research team included several important risk factors for kidney injury including:
- age,
- high blood pressure,
- diabetes,
laboratory findings from routinely available bloodwork, and higher doses of cisplatin. They found that patients who developed kidney injury from cisplatin had a considerably higher risk of death compared to those who did not…
Another key finding was that lower levels of magnesium were an important risk factor for acute kidney injury. The researchers plan to use the same rich database to try to identify therapies that might prevent kidney injury, including magnesium…
“This new tool can help an oncologist and a patient have more informed conversations about the risks and benefits of cisplatin. If a patient is at high risk, their clinical team can consider preventative measures such as administering more IV fluids before receiving cisplatin or monitoring their kidney function more closely afterward…”
Derivation and external validation of a simple risk score for predicting severe acute kidney injury after intravenous cisplatin: cohort study
“Conclusion This study found that a simple risk score based on readily available variables from patients receiving intravenous cisplatin could predict the risk of severe CP-AKI, the occurrence of which is strongly associated with death…”
Bortezomib-thalidomide-dexamethasone-cisplatin-doxorubicin-cyclophosphamide-etoposide as a Salvage and Bridging Regimen before Hematopoietic Stem Cell Transplantation for Relapsed or Refractory Multiple Myeloma
“Objective Currently, treatment of relapsed or refractory multiple myeloma is challenging. Although bortezomib-thalidomide-dexamethasone-cisplatin-doxorubicin-cyclophosphamide-etoposide (VTD-PACE), a potent combination of a proteasome inhibitor, immunomodulatory drug, and conventional chemotherapeutics, is a widely used regimen, its efficacy and safety are unclear….