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European Trial of Free Light Chain Removal by Extended Haemodialysis in Cast Nephropathy

18 Years
Open (Enrolling)
Multiple Myeloma, Cast Nephropathy, Kidney Failure

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Trial Information

European Trial of Free Light Chain Removal by Extended Haemodialysis in Cast Nephropathy

The EUropean trial of free LIght chain removal by exTEnded haemodialysis in cast nephropathy
(EuLITE) trial is a prospective, randomised, multicentre, open label clinical trial to
investigate the clinical benefit of FLC removal haemodialysis in patients with cast
nephropathy, dialysis dependent renal failure and de novo multiple myeloma. Recruitment
commenced in May 2008, in total 90 patients will be recruited. Participants will be
randomised, centrally, upon enrolment, to either trial chemotherapy and FLC removal
haemodialysis or trial chemotherapy and standard high flux haemodialysis. Trial
chemotherapy is a modified PAD regime, consisting of bortezomib, doxorubicin and
dexamethasone. FLC removal haemodialysis is undertaken using two Gambro HCO 1100 dialysers
in series, over an intensive treatment schedule. The primary outcome for the study is
independence of dialysis at 3 months. Secondary outcomes are: duration of dialysis,
reduction in serum FLC concentrations; myeloma response and survival.

Inclusion Criteria:

- Age >= 18 years

- Dialysis dependent acute renal failure (eGFR <15ml/min/1.73m2)

- Fulfils diagnostic criteria for the diagnosis of symptomatic de novo multiple

- Abnormal serum FLC ratio and a sFLC concentration > 500 mg/L

- Myeloma kidney demonstrated on a renal biopsy (cast nephropathy)

- Ability to give informed consent to partake in study

- Commencement of study within 10 days of presenting to enrolling unit

Exclusion Criteria:

- Age < 18 years

- Known advanced chronic renal failure (CKD stage IV 4-5; eGFR <30mls/min/1.73m2) or
evidence of significant chronic damage on renal biopsy

- Amyloidosis or light chain deposition disease on renal biopsy

- Previous treatment of multiple myeloma with chemotherapy

- Haemodynamic instability that precludes unsupported dialysis renal replacement

- Significant cardiac disease (myocardial infarction with in the last 6 months;
unstable angina; NYHA class III or IV heart failure; clinically significant
pericardial disease; cardiac amyloidosis)

- Advanced disease or significant co-morbidity: with poor short term prognosis,
necessitating palliation and no active or disease specific treatment.

- Inability to give informed consent

- History of allergic reaction attributable to compounds containing boron or mannitol

- History of Peripheral neuropathy or neuropathic pain (grade 2 or higher as defined by
NCI CTCAE version 3)

- Clinically significant liver dysfunction (bilirubin >1.8mg/dl (30┬Ámol/L))

- Known HIV infection

- Active uncontrolled infection

- Pregnant and lactating women

- Inability to give informed consent

- Pre-menopausal female patients of childbearing potential: positive pregnancy test or
unwilling to use effective contraception during the study

- Lactation

Type of Study:


Study Design:

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment

Outcome Measure:

Independence of haemodialysis at 3 months from enrollment (eGFR > 15mls/min/1.73m2 at 2 weeks after last dialysis session)

Outcome Time Frame:

3 months from enrollment

Safety Issue:


Principal Investigator

Paul Cockwell, MBChB

Investigator Role:

Principal Investigator

Investigator Affiliation:

University Hospital Birmingham


United Kingdom: Medicines and Healthcare Products Regulatory Agency

Study ID:

EudraCT 2007-003968-22



Start Date:

June 2008

Completion Date:

June 2012

Related Keywords:

  • Multiple Myeloma
  • Cast Nephropathy
  • Kidney Failure
  • Hemodialysis
  • Multiple myeloma
  • Cast nephropathy
  • Kidney failure
  • Kidney Diseases
  • Multiple Myeloma
  • Neoplasms, Plasma Cell
  • Renal Insufficiency