title: Fatal cardiac and renal allograft rejection with lenalidomide therapy for light-chain amyloidosis.
abstract: We describe a patient who underwent a successful heart and kidney transplant for light-chain amyloidosis. She had an excellent hematologic response to bortezomib/dexamethasone therapy. Follow-up therapy with lenalidomide was started, and the patient quickly had a fatal allograft rejection of the heart and kidney. We present evidence to support the theory that lenalidomide, a known immunomodulator, may have stimulated the immune system and precipitated the fatal rejection episode.
authors.affiliation: Department of Cardiology, Advanced Heart Failure and Transplantation, Texas Heart Institute, Houston, TX.
authors.forename: D E
authors.initials: DE
authors.lastname: Meyers
authors.forename: B
authors.initials: B
authors.lastname: Adu-Gyamfi
authors.forename: A M
authors.initials: AM
authors.lastname: Segura
authors.forename: L M
authors.initials: LM
authors.lastname: Buja
authors.forename: H R
authors.initials: HR
authors.lastname: Mallidi
authors.forename: O H
authors.initials: OH
authors.lastname: Frazier
authors.forename: L
authors.initials: L
authors.lastname: Rice
mesh_terms: D000368:Aged; D064591:Allografts; D000686:Amyloidosis / Q000188:drug therapy* / Q000378:metabolism; D003131:Combined Modality Therapy; D005260:Female; D006084:Graft Rejection / Q000139:chemically induced* / Q000401:mortality; D006331:Heart Diseases / Q000188:drug therapy; D016027:Heart Transplantation; D006801:Humans; D007147:Immunoglobulin Light Chains / Q000378:metabolism; D007155:Immunologic Factors / Q000009:adverse effects*; D007674:Kidney Diseases / Q000188:drug therapy; D016030:Kidney Transplantation; D000077269:Lenalidomide; D011379:Prognosis; D013792:Thalidomide / Q000009:adverse effects / Q000031:analogs & derivatives*
chemical_list: D007147:Immunoglobulin Light Chains; D007155:Immunologic Factors; D013792:Thalidomide; D000077269:Lenalidomide
keywords: Allograft rejection; amyloidosis; cardiac transplant; lenalidomide; renal transplant; transplantation