Multiple myeloma after kidney transplantation

Sami Safadi, Angela Dispenzieri, Hatem Amer, Morie Gertz, S Vincent Rajkumar, Suzanne R. Hayman, Martha Lacy, Nelson Leung

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Data regarding multiple myeloma (MM) that develops after kidney transplantation (KTx) are scarce. The outcomes of these patients were evaluated in a retrospective study. Methods: Patients with newly diagnosed MM after KTx were selected. Patients with a diagnosis of MM or those who received treatment for monoclonal gammopathy of renal significance (MGRS) prior to KTx were excluded. Results: Between 2001 and 2012, seven patients developed MM after KTx. Reasons for ESRD included ADPKD (1), C1q nephropathy (1), MPGN (2), hypertensive nephrosclerosis (2), and chronic interstitial nephritis (1). Before KTx, 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 KTx 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 KTx is rare. Most patients who develop MM had MGUS prior to KTx. There is significant renal involvement in these patients. Survival is not worse when compared to MM without KTx. Further work is needed to identify the best treatment options for these patients.

Original languageEnglish (US)
Pages (from-to)76-84
Number of pages9
JournalClinical Transplantation
Volume29
Issue number1
DOIs
StatePublished - Jan 1 2015

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Multiple Myeloma
Kidney Transplantation
Paraproteinemias
Kidney
Nephrosclerosis
Membranoproliferative Glomerulonephritis
Autosomal Dominant Polycystic Kidney
Interstitial Nephritis
Melphalan
Thalidomide
Survival
Plasma Cells
Dexamethasone
Chronic Kidney Failure
Allografts
Proteins
Retrospective Studies
Bone Marrow
Drug Therapy

Keywords

  • End-stage renal disease
  • Kidney transplantation
  • Monoclonal gammopathy
  • Multiple myeloma
  • Paraproteinemia
  • Renal allograft dysfunction

ASJC Scopus subject areas

  • Transplantation

Cite this

Multiple myeloma after kidney transplantation. / Safadi, Sami; Dispenzieri, Angela; Amer, Hatem; Gertz, Morie; Rajkumar, S Vincent; Hayman, Suzanne R.; Lacy, Martha; Leung, Nelson.

In: Clinical Transplantation, Vol. 29, No. 1, 01.01.2015, p. 76-84.

Research output: Contribution to journalArticle

Safadi, Sami ; Dispenzieri, Angela ; Amer, Hatem ; Gertz, Morie ; Rajkumar, S Vincent ; Hayman, Suzanne R. ; Lacy, Martha ; Leung, Nelson. / Multiple myeloma after kidney transplantation. In: Clinical Transplantation. 2015 ; Vol. 29, No. 1. pp. 76-84.
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abstract = "Background: Data regarding multiple myeloma (MM) that develops after kidney transplantation (KTx) are scarce. The outcomes of these patients were evaluated in a retrospective study. Methods: Patients with newly diagnosed MM after KTx were selected. Patients with a diagnosis of MM or those who received treatment for monoclonal gammopathy of renal significance (MGRS) prior to KTx were excluded. Results: Between 2001 and 2012, seven patients developed MM after KTx. Reasons for ESRD included ADPKD (1), C1q nephropathy (1), MPGN (2), hypertensive nephrosclerosis (2), and chronic interstitial nephritis (1). Before KTx, 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 KTx 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 KTx is rare. Most patients who develop MM had MGUS prior to KTx. There is significant renal involvement in these patients. Survival is not worse when compared to MM without KTx. Further work is needed to identify the best treatment options for these patients.",
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AU - Lacy, Martha

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N2 - Background: Data regarding multiple myeloma (MM) that develops after kidney transplantation (KTx) are scarce. The outcomes of these patients were evaluated in a retrospective study. Methods: Patients with newly diagnosed MM after KTx were selected. Patients with a diagnosis of MM or those who received treatment for monoclonal gammopathy of renal significance (MGRS) prior to KTx were excluded. Results: Between 2001 and 2012, seven patients developed MM after KTx. Reasons for ESRD included ADPKD (1), C1q nephropathy (1), MPGN (2), hypertensive nephrosclerosis (2), and chronic interstitial nephritis (1). Before KTx, 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 KTx 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 KTx is rare. Most patients who develop MM had MGUS prior to KTx. There is significant renal involvement in these patients. Survival is not worse when compared to MM without KTx. Further work is needed to identify the best treatment options for these patients.

AB - Background: Data regarding multiple myeloma (MM) that develops after kidney transplantation (KTx) are scarce. The outcomes of these patients were evaluated in a retrospective study. Methods: Patients with newly diagnosed MM after KTx were selected. Patients with a diagnosis of MM or those who received treatment for monoclonal gammopathy of renal significance (MGRS) prior to KTx were excluded. Results: Between 2001 and 2012, seven patients developed MM after KTx. Reasons for ESRD included ADPKD (1), C1q nephropathy (1), MPGN (2), hypertensive nephrosclerosis (2), and chronic interstitial nephritis (1). Before KTx, 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 KTx 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 KTx is rare. Most patients who develop MM had MGUS prior to KTx. There is significant renal involvement in these patients. Survival is not worse when compared to MM without KTx. Further work is needed to identify the best treatment options for these patients.

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