Renal Allograft Failure After Ipilimumab Therapy for Metastatic Melanoma: A Case Report and Review of the Literature

• Published in: Transplantation proceedings 2016-11, Vol.48 (9), p.3137-3141
• Main Authors: Jose, A, Yiannoullou, P, Bhutani, S, Denley, H, Morton, M, Picton, M, Summers, A, van Dellen, D, Augustine, T
• Format: Article
• Language: English
• Subjects: Antibodies, Monoclonal - adverse effects; Antineoplastic Agents - adverse effects; Graft Rejection - chemically induced; Graft Rejection - immunology; Humans; Ipilimumab; Kidney - immunology; Kidney Transplantation; Male; Melanoma - drug therapy; Middle Aged; Renal Insufficiency - chemically induced; Surgery; Transplantation, Homologous; Uveal Neoplasms - drug therapy
• ISSN: 0041-1345; 1873-2623
• DOI: 10.1016/j.transproceed.2016.07.019

Abstract Transplant recipients are at an increased risk of malignant melanoma, a result of chronic immunosuppression. Ipilimumab is a newer biological agent targeting T lymphocytes to potentiate an immune response against melanoma, and the use of this agent results in a new adverse effect profile that the clinician must be aware of while a patient is on therapy. We report the case of a male renal transplant recipient who developed graft failure while treated with ipilimumab and minimal immunosuppressive therapy for metastatic ocular melanoma, with biopsy evidence of glomerulonephritis and acute rejection. We highlight the immunological side effects that can manifest from ipilimumab therapy and conclude that it did influence graft function in this patient. Our case illustrates the importance of weighing the risks and benefits to graft function and long-term survival as well as the importance of considering other treatment modalities in this specific group of melanoma patients.