Autologous stem cell transplantation in EBV-positive post-renal transplant refractory multiple myeloma: A case report and literature review

Abstract

Renal transplant recipients exhibit an increased risk of developing plasma cell neoplasms (PCNs; comprising multiple myeloma and plasmacytoma); however, multiple myeloma manifesting with refractory extramedullary plasmacytomas associated with Epstein-Barr virus are markedly rare in these patients. In the present case report, an unusual case of refractory multiple myeloma with multiple extramedullary plasmacytoma (including liver, vertebrae, breast, muscle, skin and soft tissues) was presented. The patient exhibited mild bone marrow infiltration which was successfully treated with novel agents, including bortezomib and lenalidomide, followed by autologous stem cell transplantation (ASCT). In addition, the patient was a renal transplant recipient who achieved a partial clinical remission with controllable therapy-related toxicity effects. Therefore, the present case indicated that ASCT is an effective and safe salvage therapy for renal transplant recipients with secondary extramedullary plasmacytomas and who are resistant to traditional chemotherapy (bortezomib and lenalidomide). ASCT was well-tolerated in the renal transplant recipient.

Gender and the length of time since autologous hematopoietic stem cell transplantation—What is their influence on the immune reconstitution in multiple myeloma patients?

“…The studied females and males were slightly older than females and males with MM studied by Wichert et al [8], but younger than females and males described by other authors [9][10][11][12][13][14][15][16]. Age of the patients described in case reports was highly diverse [15,[17][18][19][20][21].…”