Follow-up Monoclonal Gammopathy of Undetermined Significance in Kidney Transplant

Cuéllar-García, Carolina; Ruiz-Mateos, C. Sevillano; Blanca, María Auxiliadora Mazuecos; Mejía, Carlos Narváez; Valle, Maikel; Reina, V. Martin; Bernal, Marina; Cobo, M.; Lopez, R. Rodriguez; Hohr, C. de Cos; Garrastazul, M.P.; Marchante, Inmaculada; Coll, Antonio Paz; Huelva, Francisco Javier Capote

doi:10.1016/j.transproceed.2014.11.021

Cited by 16 publications

(13 citation statements)

References 4 publications

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“…In KT, monoclonal gammopathy is 10 times more frequent than in the general population, but is not associated with a high occurrence of PCN [33–36]. Most of these MGUS are transient, and probably reflect the temporary loss of control of the B-cell lymphoid population secondary to immunosuppressive therapy [33,34,37].…”

Section: Discussionmentioning

confidence: 99%

Plasma cell neoplasia after kidney transplantation: French cohort series and review of the literature

et al. 2017

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Although post-transplant lymphoproliferative disorder (PTLD) is the second most common type of cancer in kidney transplantation (KT), plasma cell neoplasia (PCN) occurs only rarely after KT, and little is known about its characteristics and evolution. We included twenty-two cases of post-transplant PCN occurring between 1991 and 2013. These included 12 symptomatic multiple myeloma, eight indolent myeloma and two plasmacytomas. The median age at diagnosis was 56.5 years and the median onset after transplantation was 66.7 months (2–252). Four of the eight indolent myelomas evolved into symptomatic myeloma after a median time of 33 months (6–72). PCN-related kidney graft dysfunction was observed in nine patients, including six cast nephropathies, two light chain deposition disease and one amyloidosis. Serum creatinine was higher at the time of PCN diagnosis than before, increasing from 135.7 (±71.6) to 195.9 (±123.7) μmol/l (p = 0.008). Following transplantation, the annual rate of bacterial infections was significantly higher after the diagnosis of PCN, increasing from 0.16 (±0.37) to 1.09 (±1.30) (p = 0.0005). No difference was found regarding viral infections before and after PCN. Acute rejection risk was decreased after the diagnosis of PCN (36% before versus 0% after, p = 0.004), suggesting a decreased allogeneic response. Thirteen patients (59%) died, including twelve directly related to the hematologic disease. Median graft and patient survival was 31.7 and 49.4 months, respectively. PCN after KT occurs in younger patients compared to the general population, shares the same clinical characteristics, but is associated with frequent bacterial infections and relapses of the hematologic disease that severely impact the survival of grafts and patients.

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Section: Discussionmentioning

confidence: 99%

Plasma cell neoplasia after kidney transplantation: French cohort series and review of the literature

et al. 2017

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“…18 Generally, the MGUS is thought to be transient and not increase the risk of developing a PCN or other plasma cell dyscrasias. 7,19 The median age at diagnosis with AL amyloidosis in this study was only 50 years and yet the time from transplantation to a diagnosis of AL amyloidosis was 12 years suggesting that AL amyloidosis maybe a late complication perhaps reflecting an indolent form of PTLD. Without treatment progressive AL amyloidosis risks graft and eventually other organ failure and death.…”

Section: Discussionmentioning

confidence: 73%

Amyloidosis Diagnosed in Solid Organ Transplant Recipients

et al. 2020

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AA-AA amyloidosis (previously known as secondary amyloidosis) AL-AL amyloidosis (previously known as primary amyloidosis) CR-complete response CRP-C-reactive protein MGUS-monoclonal gammopathy of undetermined significance NR-no response PCN-plasma cell neoplasia PD-progressive disease PR-partial response PTLD-post-transplant lymphoproliferative disorder SAA-serum amyloid A protein VGPR-very good partial response wtATTR-wild type transthyretin amyloidosis ConclusionsThis series is the first description of amyloidosis post solid organ transplant; 30 cases among 5,112 amyloid patients over 24 years suggests that amyloidosis may occur post solid organ transplantation with an overall poor survival.

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“…A study of 16 transplant recipients with pretransplant MGUS, showed that two developed post-transplantation lymphoproliferative disorder (PTLD) [12]. As organ recipients with MGUS are at risk of PTLD, they should be regularly monitored for antibodies against Epstein-Barr virus (EBV) and cytomegalovirus (CMV).…”

Section: Discussionmentioning

confidence: 99%

Short-term outcome and quality of life in kidney transplant recipient with monoclonal gammopathy

et al. 2016

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Monoclonal gammopathy of undetermined significance (MGUS) is the common pre-malignant B cell disorders with a general prevalence of 3-5 % at age over 50. Because of the potential malignant transformation and immune insufficiency, pre-transplant MGUS recipient should be carefully followed after allograft transplantation. The post-transplant prognosis and quality of life (QOL) in patient with MGUS have not yet been fully determined. The aim of this study is to evaluate function and pathology of the renal allograft and self-assessment QOL changes during 2 years after transplantation in our case of MGUSbearing recipient. We here studied the clinical course and QOL improvement before and 20 months after transplant in a 56-year-old woman, who had pre-existing MGUS and underwent living donor kidney transplantation. After the renal allograft transplant, the patients maintained normal GFR and had neither acute rejections nor histologic evidence of renal injuries related to the monoclonal gammopathy on the protocol biopsy of 1 year post-transplant. During further 20 months follow-up, the pre-transplant MGUS remained uneventful without any hematologic abnormalities and other medical complications, i.e., infection. Evaluation of QOL using a self-assessment questionnaire showed significant improvement for physical and mental items on both 6 and 18 months post-transplant. The renal transplant thus successfully provided a greater satisfaction for the recipient on both physical and mental health aspects. Our observations suggest that renal transplantation is beneficial even in those who had pre-existing

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Follow-up Monoclonal Gammopathy of Undetermined Significance in Kidney Transplant

Cited by 16 publications

References 4 publications

Plasma cell neoplasia after kidney transplantation: French cohort series and review of the literature

Plasma cell neoplasia after kidney transplantation: French cohort series and review of the literature

Amyloidosis Diagnosed in Solid Organ Transplant Recipients

Short-term outcome and quality of life in kidney transplant recipient with monoclonal gammopathy

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