{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T20:21:26Z","timestamp":1789676486266,"version":"4.0.1"},"reference-count":17,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T00:00:00Z","timestamp":1767657600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Renal impairment is a frequent and severe complication of multiple myeloma, most commonly caused by light-chain cast nephropathy. Therapeutic plasma exchange (TPE) has been proposed as an adjunctive approach to rapidly reduce circulating free light chains; however, its clinical benefit remains controversial. Methods: We retrospectively analyzed 71 patients treated between 2013 and 2023, of whom 30 received TPE in addition to anti-myeloma therapy and 41 received anti-myeloma therapy alone. Renal outcomes were assessed within a predefined early treatment window encompassing the first 4\u20136 cycles of therapy. Renal response was defined as a \u226550% reduction in serum creatinine and\/or dialysis independence. Multivariable logistic regression and sensitivity analyses were performed to adjust for baseline imbalances, including renal function and anti-myeloma backbone therapy. Results: Although renal function improved significantly over time in both groups, renal response rates were comparable between patients treated with and without TPE (40% vs. 36.6%). In multivariable analysis, TPE was not independently associated with renal response. Importantly, in a sensitivity analyses restricted to patients receiving bortezomib-based regimens, the addition of TPE remained unassociated with improved renal outcomes. Conclusions: In this real-world cohort, adjunctive TPE did not confer a significant advantage in renal recovery or dialysis independence beyond contemporary anti-myeloma therapy. These findings indicate that renal recovery is predominantly driven by effective anti-myeloma treatment rather than extracorporeal light-chain removal.<\/jats:p>","DOI":"10.3390\/jcm15020417","type":"journal-article","created":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T11:13:18Z","timestamp":1767697998000},"page":"417","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["The Role of Therapeutic Plasma Exchange in the Management of Myeloma-Related Cast Nephropathy: A 10-Year Real-World Cohort Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-4533-9138","authenticated-orcid":false,"given":"Hasan","family":"Salur","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Antalya City Hospital, Antalya 07080, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5897-6514","authenticated-orcid":false,"given":"Unal","family":"Atas","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Akdeniz University, Antalya 07100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4285-4499","authenticated-orcid":false,"given":"Nurcan","family":"Alhan","sequence":"additional","affiliation":[{"name":"Education and Research Hospital Hematology Clinic, Alanya Alaaddin Keykubat University, Antalya 07425, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2754-8995","authenticated-orcid":false,"given":"Ece","family":"Vural","sequence":"additional","affiliation":[{"name":"Clinic of Hematology, Ankara Liv Hospital, Ankara 07425, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7129-418X","authenticated-orcid":false,"given":"Utku","family":"Iltar","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Akdeniz University, Antalya 07100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0455-1382","authenticated-orcid":false,"given":"Orhan Kemal","family":"Yucel","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Akdeniz University, Antalya 07100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6687-0189","authenticated-orcid":false,"given":"Ozan","family":"Salim","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Department of Internal Medicine, Division of Hematology, Akdeniz University, Antalya 07100, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.4065\/80.10.1371","article-title":"Multiple myeloma: Diagnosis and treatment","volume":"80","author":"Rajkumar","year":"2005","journal-title":"Mayo Clin. 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Hematol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/417\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T11:26:33Z","timestamp":1767698793000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/417"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,6]]},"references-count":17,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcm15020417"],"URL":"https:\/\/doi.org\/10.3390\/jcm15020417","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,6]]}}}