Light chains: heavy burden in kidney transplantation.
Plasma cell dyscrasias are frequently encountered malignancies which are often associated with kidney disease through the production of monoclonal immunoglobulin (Ig). Recent advances in the field include the availability of an assay for free light chains, the introduction of new agents which more effectively target malignant plasma cells, and refinements in the application of stem-cell transplantation. Well-selected patients with plasma cell dyscrasias whose monoclonal Ig is well controlled may be candidates for kidney transplantation. Kidney transplant patients with allograft dysfunction from recurrent or de novo monoclonal Ig deposition can be successfully identified and treated with these new approaches.
Heher
Eliot C
EC
Division of Nephrology and Transplantation Center, Massachusetts General Hospital, Boston, MA 02114, USA. eheher@partners.org
Spitzer
Thomas R
TR
Goes
Nelson B
NB
D000911:Antibodies, Monoclonal / Q000276:immunology; D001536:Bence Jones Protein / Q000032:analysis; D001706:Biopsy; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000276:immunology*; D007136:Immunoglobulins / Q000032:analysis; D016030:Kidney Transplantation / Q000276:immunology* / Q000473:pathology; D010265:Paraproteinemias / Q000276:immunology* / Q000473:pathology / Q000601:surgery; D010950:Plasma Cells / Q000276:immunology; D012008:Recurrence; D016896:Treatment Outcome
D000911:Antibodies, Monoclonal; D007147:Immunoglobulin Light Chains; D007136:Immunoglobulins; D001536:Bence Jones Protein