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Multiple myeloma after kidney transplantation
Author(s) -
Safadi Sami,
Dispenzieri Angela,
Amer Hatem,
Gertz Morie A.,
Rajkumar S. Vincent,
Hayman Suzanne R.,
Lacy Martha Q.,
Leung Nelson
Publication year - 2015
Publication title -
clinical transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 76
eISSN - 1399-0012
pISSN - 0902-0063
DOI - 10.1111/ctr.12482
Subject(s) - medicine , multiple myeloma , monoclonal gammopathy of undetermined significance , lenalidomide , melphalan , transplantation , thalidomide , bortezomib , urology , gastroenterology , kidney disease , surgery , monoclonal , immunology , monoclonal antibody , antibody
Background Data regarding multiple myeloma ( MM ) that develops after kidney transplantation ( KT x) are scarce. The outcomes of these patients were evaluated in a retrospective study. Methods Patients with newly diagnosed MM after KT x were selected. Patients with a diagnosis of MM or those who received treatment for monoclonal gammopathy of renal significance ( MGRS ) prior to KT x were excluded. Results Between 2001 and 2012, seven patients developed MM after KT x. Reasons for ESRD included ADPKD (1), C1q nephropathy (1), MPGN (2), hypertensive nephrosclerosis (2), and chronic interstitial nephritis (1). Before KT x, only four patients had monoclonal protein studies, four had monoclonal gammopathy of undermined significance ( MGUS ), and two of them had clonal plasma cells in bone marrow. Median follow‐up after MM was 70 months (range 19–100). Median survival was 80 months. Median time from KT x to MM was 72 months (range 3–204 months). The Kidney allograft failed in four patients due to monoclonal protein‐related renal disease. Five patients received chemotherapy: bortezomib (n = 3), lenalidomide (n = 2), melphalan (n = 1), thalidomide (n = 1), pomalidomide (n = 1), and high‐dose dexamethasone (n = 1). Three patients received ASCT . Conclusion Multiple myeloma after KT x is rare. Most patients who develop MM had MGUS prior to KT x. There is significant renal involvement in these patients. Survival is not worse when compared to MM without KT x. Further work is needed to identify the best treatment options for these patients.