{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T01:08:54Z","timestamp":1789434534934,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"21","license":[{"start":{"date-parts":[[2025,11,5]],"date-time":"2025-11-05T00:00:00Z","timestamp":1762300800000},"content-version":"vor","delay-in-days":4,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T00:00:00Z","timestamp":1761955200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82370192"],"award-info":[{"award-number":["82370192"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["U24A20680"],"award-info":[{"award-number":["U24A20680"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100018542","name":"Natural Science Foundation of Sichuan Province","doi-asserted-by":"publisher","award":["2024NSFSC1697"],"award-info":[{"award-number":["2024NSFSC1697"]}],"id":[{"id":"10.13039\/501100018542","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Previous studies mainly focused on renal impairment (RI) at multiple myeloma (MM) diagnosis, with few investigating new\u2010onset RI post\u2010MM diagnosis. This study aims to indicate the incidence, clinical characteristics and predictive value of new\u2010onset RI in MM patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We conducted a multicenter, retrospective cohort study including 1953 newly diagnosed MM patients from West China Hospital from July 1, 2008, to February 30, 2024 and the international MMRF\u2010CoMMpass database. Among them, 1770 patients received novel therapeutic agents including immunomodulatory drugs (IMiDs) and proteasome inhibitors (PIs) as first\u2010line therapy. RI was defined as serum creatinine higher than 2\u2009mg\/dL or impaired creatinine clearance (&lt;\u200940\u2009mL\/min\/1.73m\n                      <jats:sup>2<\/jats:sup>\n                      ). The association between new\u2010onset RI and mortality risk was investigated by Kaplan\u2013Meier analysis and Cox proportional hazard models.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the cohort, 16.6% developed new\u2010onset RI, with the majority (67.1%) occurring within 2\u2009years post\u2010MM diagnosis. The median overall survival (OS) was significantly shorter in new\u2010onset RI than in those without RI (68 vs. 122\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). New\u2010onset RI was an independent risk factor for mortality (HR 1.55, 95% CI 1.28\u20131.88,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001), and earlier onset of RI was associated with a higher mortality risk. Moreover, patients with recovery of renal function had prolonged OS compared to those without recovery (95 vs. 64.8\u2009months,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). Older age, higher stage of the international stage system (ISS) and RI at diagnosis seemed to be risk factors for new\u2010onset RI, while first\u2010line therapy with PIs and IMiDs combinations was associated with a lower risk of RI development (HR 0.69, 95% CI 0.51\u20130.94,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.017).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In conclusion, the incidence of new\u2010onset RI is high in MM, and is a significant risk factor for mortality, posing a substantial threat to MM patients. Early identification of high\u2010risk patients for new\u2010onset RI and prompt preventive strategies is critical for improving MM prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration<\/jats:title>\n                    <jats:p>\n                      This study was registered by the Chinese Clinical Trial Registry (ChiCTR2400081476,\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"https:\/\/www.chictr.org.cn\">https:\/\/www.chictr.org.cn<\/jats:ext-link>\n                      )\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.71361","type":"journal-article","created":{"date-parts":[[2025,11,6]],"date-time":"2025-11-06T01:59:54Z","timestamp":1762394394000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Incidence, Clinical Features, and Prognostic 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