Renal Transplantation in Light-Chain Multiple Myeloma

Walker, Frank C.; Bear, Robert A.

doi:10.1159/000166684

Cited by 37 publications

(5 citation statements)

References 12 publications

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“…The main complications were infections and recurrence of renal damage (light chain deposits). Other studies [10,11] reported that LCDD recurred in 50% of these patients after kidney transplantation. Most of the time, the immu nosuppressive regime included cyclophosphamide and prednisolone.…”

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confidence: 83%

Long-Term Follow-Up of Monoclonal Gammopathy of Undetermined Significance in Transplant Patients

et al. 1994

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We report the long-term follow-up of 5 patients (4 kidney, 1 heart recipients) having a pretransplant monoclonal gammopathy of undetermined significance (MGUS). The follow-up of MGUS before transplantation was 41.2 ± 40.7 months (range 2-108). The monoclonal component isotype was IgG-kappa in 3 cases and IgA-lambda in 2. The pretransplant level of the monoclonal component was 11.1 ± 4.8 g/l (range 4-15.6). The transplant recipients who had MGUS were older than our other transplant patients. All but one of them received ciclosporine A. They did not experience more rejection or infectious complications than the others. Their posttransplant follow-up ranged from 3 to 9 years. The monoclonal component level remained stable in 2 patients but increased in 3 (33-225%). This was not correlated with bone marrow plasmocytosis. Two patients developed smoldering myeloma indicated by bone marrow immunochemistry studies which showed monomorph monoclonal plasma cells; nevertheless, they did not have cytopenia or bone lytic lesions. This percentage is higher than in the Kyle study but we cannot assume that it is due to ciclosporine A since our study sample is too small. In conclusion, MGUS is not a contraindication to organ transplantation.

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confidence: 83%

Long-Term Follow-Up of Monoclonal Gammopathy of Undetermined Significance in Transplant Patients

et al. 1994

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“…The primary cause of death was always overwhelming infection with sepsis. Another patient has been reported to be alive and well about 3 1 /2 years after transplantation (34). Interestingly, no significant deterioration in renal function was noted spite of myeloma allograft involvement in three of the cases.…”

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confidence: 87%

Dialysis and Transplantation in Multiple Myeloma

Barton

1984

Int J Artif Organs

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“…Both haemodialysis and peritoneal dialysis are equally effective long‐term renal replacement therapies. Renal transplantation is an option for only a very small number of highly selected patients with good prognosis disease and who have achieved plateau after treatment of their myeloma (Humphrey et al , 1975; Walker & Bear, 1983). As regards further treatment of the myeloma, HDT with autologous SCT can be undertaken in patients with moderate to severe renal failure, but the available data suggests that the risks of HDT are increased and therefore transplant should take place only in a centre with appropriate expertise.…”

Section: The Management Of Patients With Renal Failurementioning

confidence: 99%

Diagnosis and management of multiple myeloma

2001

Br J Haematol

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Clinical presentationClinical presentation is varied. Common presentations of myeloma include bone pain, recurrent or persistent infection, anaemia, renal impairment, or a combination of these. Some patients are asymptomatic, abnormalities being identified on blood tests being carried out for other clinical reasons.Presenting features, which require urgent specialist referral, include: X Standard X-ray imaging of bones, particularly the axial skeleton (NB radionucleide bone scanning is not usually helpful in the diagnosis of myeloma).Appropriate setting for the management of myeloma A consultant haematologist or oncologist, who is part of an approved Cancer Network in accordance with UK National Health Service (NHS) strategy, should lead the care of patients with multiple myeloma. Effective and high-quality care in myeloma requires a multispecialty and multidisciplinary team familiar with the range of clinical problems likely to be encountered. There are currently a number of government initiatives focused on improving standards of care, including the NHS Cancer Plan. Clinicians managing patients must be aware of these initiatives and develop strategies to achieve these standards locally. The centre should be capable of achieving the 2-week government standards for referral. It needs to maintain a database of cases for registration and clinical audit. A minimum data set for myeloma registration and audit is included as Appendix 1. Improved registration and systems to facilitate this are part of the NHS Cancer strategy.The following represent the core range of essential accessible expertise and services, which may be available locally or in a neighbouring hospital. There should be clear policies and protocols for access to these services.X Haematology/Oncology nurse specialists X Clinical pathology X Diagnostic radiology X Pharmacy facilities and expertise for dispensing cytotoxic drugs X Renal services, including rapid access to haemodialysis DIAGNOSIS, INVESTIGATION AND INDICATIONS FOR TREATMENT Diagnosis and investigationPatients typically present with bone pain, renal impairment, anaemia, or a combination of these. Myeloma should also be considered in patients with unexplained backache, loss of height or radiological evidence of osteoporosis, or recurrent bacterial infection. Asymptomatic patients may be diagnosed on routine testing.Investigation of a patient with suspected myeloma should Guideline 523

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Renal Transplantation in Light-Chain Multiple Myeloma

Cited by 37 publications

References 12 publications

Long-Term Follow-Up of Monoclonal Gammopathy of Undetermined Significance in Transplant Patients

Long-Term Follow-Up of Monoclonal Gammopathy of Undetermined Significance in Transplant Patients

Dialysis and Transplantation in Multiple Myeloma

Diagnosis and management of multiple myeloma

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