title: 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.
authors.affiliation: Department of Hematology and Oncology, Nagoya Daini Red Cross Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya 466-8650, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Aoki
authors.forename: Masanobu
authors.initials: M
authors.lastname: Kasai
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Harada
authors.forename: Erina
authors.initials: E
authors.lastname: Matsubara
authors.forename: Takanobu
authors.initials: T
authors.lastname: Morishita
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Suzuki
authors.forename: Makoto
authors.initials: M
authors.lastname: Tsujita
authors.forename: Norihiko
authors.initials: N
authors.lastname: Goto
authors.forename: Akio
authors.initials: A
authors.lastname: Katayama
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Watarai
authors.forename: Kazuharu
authors.initials: K
authors.lastname: Uchida
authors.forename: Masafumi
authors.initials: M
authors.lastname: Ito
authors.forename: Hiroo
authors.initials: H
authors.lastname: Saji
authors.forename: Toyonori
authors.initials: T
authors.lastname: Tsuzuki
authors.forename: Toshiki
authors.initials: T
authors.lastname: Uchida
authors.forename: Michinori
authors.initials: M
authors.lastname: Ogura
mesh_terms: D000328:Adult; D002872:Chromosome Deletion; D002886:Chromosomes, Human, Pair 17; D005921:Glomerulonephritis / Q000235:genetics / Q000276:immunology / Q000628:therapy; D006085:Graft Survival; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects* / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D009101:Multiple Myeloma / Q000235:genetics / Q000276:immunology / Q000628:therapy*; D011183:Postoperative Complications / Q000235:genetics / Q000276:immunology / Q000628:therapy*; D058496:Smith-Magenis Syndrome; D019172:Transplantation Conditioning; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents