Hematopoietic Cell and Renal Transplantation in Plasma Cell Dyscrasia Patients

Gammopathies, multiple myeloma, and amyloidosis are plasma dyscrasias characterized by clonal proliferation and immunoglobulin overproduction. Renal impairment is the most common and serious complication with an incidence of 20–30% patients at the diagnosis. Kidney transplant has not been considered...

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Bibliographic Details
Published in:Cell Transplantation 2016-06, Vol.25 (6), p.995-1005
Main Authors: Baraldi, Olga, Grandinetti, Valeria, Donati, Gabriele, Comai, Giorgia, Battaglino, Giuseppe, Cuna, Vania, Capelli, Irene, Sala, Elisa, La Manna, Gaetano
Format: Article
Language:English
Subjects:
Amyloidosis
Dialysis
Gammopathy
Hematopoietic Stem Cell Transplantation
Hematopoietic Stem Cells - cytology
Humans
Immunosuppressive agents
Kidney Transplantation
Kidney transplants
Multiple myeloma
Paraproteinemias - therapy
Plasma
Remission
Renal function
Stem cell transplantation
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Summary:Gammopathies, multiple myeloma, and amyloidosis are plasma dyscrasias characterized by clonal proliferation and immunoglobulin overproduction. Renal impairment is the most common and serious complication with an incidence of 20–30% patients at the diagnosis. Kidney transplant has not been considered feasible in the presence of plasma dyscrasias because the immunosuppressive therapy may increase the risk of neoplasia progression, and paraproteins may affect the graft. However, recent advances in clinical management of multiple myeloma and other gammopathies allow considering kidney transplant as a possible alternative to dialysis. Numerous evidence indicates the direct relationship between hematological remission and renal function restoring. The combination of kidney and hematopoietic cell transplant has been reported as a promising approach to reestablish end-organ function and effectively treat the underlying disease. This review describes current protocols used to perform kidney transplantation in patients with plasma dyscrasias.
ISSN:0963-6897
1555-3892
DOI:10.3727/096368915X688560