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Stable renal engraftment in a patient following successful tandem autologous/reduced-intensity conditioning allogeneic transplantation for treatment of multiple myeloma with del(17p) that developed as a post-transplantation lymphoproliferative disease following renal transplantation.

Abstract
Multiple myeloma (MM) developing after renal transplantation is rare. From January 1972 to December 2011, a total of 1,485 patients underwent renal transplantation in Nagoya Daini Red Cross Hospital; 14 (0.9%) of these recipients developed post-transplantation lymphoproliferative disorders (PTLDs) including two plasma cell neoplasms. Here, we report the clinical course of a 35-year-old male with immunoglobulin G k-type MM of recipient origin that developed 5 years after renal transplantation from a human leukocyte antigen (HLA)-haploidentical female sibling donor, which was performed to address dialysis-dependent chronic glomerulonephritis. Cytogenetic analysis revealed significant del(17p) abnormalities in myeloma cells. After non-response to bortezomib treatment, the patient achieved partial response with a thalidomide-containing salvage regimen and underwent successful tandem autologous/reduced-intensity conditioning allogeneic hematopoietic stem cell transplantation (HSCT) from an unrelated male donor matched for seven of eight HLAs. At the 8-month follow-up time point, the patient's performance status remained good, and the transplanted kidney remains functional without rejection. To the best of our knowledge, this is the first report of a successful use of allogeneic HSCT for a patient who developed MM as a PTLD after renal transplantation. This patient has a transplanted kidney and transplanted hematopoietic cells that currently coexist without rejection.
AuthorsTomohiro Aoki, Masanobu Kasai, Yasuhiko Harada, Erina Matsubara, Takanobu Morishita, Tatsuya Suzuki, Makoto Tsujita, Norihiko Goto, Akio Katayama, Yoshihiko Watarai, Kazuharu Uchida, Masafumi Ito, Hiroo Saji, Toyonori Tsuzuki, Toshiki Uchida, Michinori Ogura
JournalInternational journal of hematology (Int J Hematol) Vol. 98 Issue 1 Pg. 129-34 (Jul 2013) ISSN: 1865-3774 [Electronic] Japan
PMID23666631 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Immunosuppressive Agents
Topics
  • Adult
  • Chromosome Deletion
  • Chromosomes, Human, Pair 17
  • Glomerulonephritis (genetics, immunology, therapy)
  • Graft Survival
  • Hematopoietic Stem Cell Transplantation (adverse effects)
  • Humans
  • Immunocompromised Host
  • Immunosuppressive Agents (adverse effects, therapeutic use)
  • Kidney Transplantation (adverse effects)
  • Male
  • Multiple Myeloma (genetics, immunology, therapy)
  • Postoperative Complications (genetics, immunology, therapy)
  • Smith-Magenis Syndrome
  • Transplantation Conditioning
  • Transplantation, Autologous
  • Transplantation, Homologous
  • Treatment Outcome

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