Living Donor Kidney and Autologous Stem Cell Transplantation for Primary Systemic Amyloidosis (AL) with Predominant Renal Involvement

Abstract

Primary systemic amyloidosis (AL) is characterized by multiorgan deposition of monoclonal immunoglobulin light chain. Renal involvement is common and im-

Multiple Myeloma

“…However, with the improved prognosis in patients with ESRD and AL-amyloidosis related to ASCT, renal transplantation has become a viable option. The outcome of renal transplantation in eight patients (seven living related and one cadaveric) with successful ASCT has been encouraging (135,144). Graft survival ranged from 18 to 72 mo without clinical or histologic evidence of recurrence.…”

Current status of hematopoietic cell transplantation in the treatment of systemic amyloid light-chain amyloidosis

“…74 Another approach was published by the Mayo Clinic, where they transplanted living donor renal allografts followed by full dose HDM. 75 In an expanded cohort of 19 patients, 79% were alive after a median follow-up of 41 months. 76 Re´sume´: organ transplantation is a therapeutic option in selected patients with kidney or cardiac failure.…”

Kidney Disease and Multiple Myeloma

“…Select patients with Ig amyloid and MIDD can also be successfully treated with autologous SCT, although patients with significant systemic involvement experience unacceptable treatment-related mortality and thus, are not candidates for this approach. Patient selection has been suggested as an explanation for the apparent advantage of SCT over standard therapy (85,86). Allogeneic SCT is potentially curative for small numbers of patients because of a mild graft-versus-myeloma effect, but its use remains experimental in this setting (87).…”