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Successful kidney transplantation in a patient with pre‐existing chronic myeloid leukemia treated with imatinib
Author(s) -
Thiem Ursula,
BuxhoferAusch Veronika,
Kranewitter Wolfgang,
Webersinke Gerald,
Enkner Wolfgang,
Cejka Daniel
Publication year - 2021
Publication title -
american journal of transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.89
H-Index - 188
eISSN - 1600-6143
pISSN - 1600-6135
DOI - 10.1111/ajt.16194
Subject(s) - medicine , contraindication , transplantation , kidney disease , imatinib , kidney transplantation , basiliximab , malignancy , chronic myelogenous leukemia , myeloid leukemia , imatinib mesylate , gastroenterology , leukemia , pathology , alternative medicine
Active malignancy is an absolute contraindication to kidney transplantation. As for chronic myeloid leukemia (CML), a Philadelphia chromosome‐positive myeloproliferative neoplasm, the introduction of tyrosine kinase inhibitors has transformed CML from a lethal into a manageable chronic disease with a close‐to‐normal life expectancy. To date it is unknown whether kidney transplantation can be safely performed in patients with pre‐existing CML. We describe the clinical course of a 57‐year‐old male patient with chronic kidney disease caused by reflux nephropathy. This patient had undergone first kidney transplantation 20 years earlier and had again been on chronic hemodialysis for 6 years when CML was diagnosed. First‐line therapy with 400 mg imatinib daily was well tolerated and induced an optimal cytogenetic and molecular response 3 months after initiation. One and a half years after CML diagnosis, a second kidney transplantation from a deceased donor was performed. Immunosuppression included basiliximab, tacrolimus, mycophenolate mofetil, and corticosteroids. Currently, 2 years posttransplant, renal allograft function is stable (serum creatinine 1.09 mg/dL, estimated glomerular filtration rate 75 mL/min per 1.73 m 2 ), and CML remains in deep molecular remission with imatinib. Imatinib‐treated CML in deep molecular remission could be regarded as inactive malignancy and may therefore not be viewed as an absolute contraindication to kidney transplantation.