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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

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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.

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Conflict of interest

The authors declare that they have no conflict of interest relevant to this manuscript.

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Authors and Affiliations

  1. Department of Hematology and Oncology, Nagoya Daini Red Cross Hospital, 2-9 Myoken-cho, Showa-ku, Nagoya, 466-8650, Japan

    Tomohiro Aoki, Masanobu Kasai, Yasuhiko Harada, Erina Matsubara, Takanobu Morishita, Tatsuya Suzuki, Toshiki Uchida & Michinori Ogura

  2. Department of Transplant Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Japan

    Makoto Tsujita, Norihiko Goto & Yoshihiko Watarai

  3. Department of Transplant Surgery, Masuko Memorial Hospital, Nagoya, Japan

    Akio Katayama

  4. Department of Organ Transplant Surgery, Aichi Medical University, Nagoya, Japan

    Kazuharu Uchida

  5. Department of Pathology, Nagoya Daiichi Red Cross Hospital, Nagoya, Japan

    Masafumi Ito

  6. HLA Laboratory, Kyoto, Japan

    Hiroo Saji

  7. Department of Pathology, Nagoya Daini Red Cross Hospital, Nagoya, Japan

    Toyonori Tsuzuki

Authors
  1. Tomohiro Aoki
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  2. Masanobu Kasai
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  12. Masafumi Ito
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  16. Michinori Ogura
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Correspondence to Michinori Ogura.

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Aoki, T., Kasai, M., Harada, Y. et al. 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. Int J Hematol 98, 129–134 (2013). https://doi.org/10.1007/s12185-013-1355-3

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  • DOI: https://doi.org/10.1007/s12185-013-1355-3

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