Disappearance of immunoglobulins from persistent renal amyloid deposits following stem cell transplantation for heavy-and light-chain amyloidosis

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
Sami SafadiSamih H Nasr

Abstract

Immunoglobulin (Ig)-related amyloidosis is the most common type of systemic amyloidosis in the developed countries and involves the kidney in most cases. Clinical remission can be achieved with chemotherapy and/or autologous stem cell transplantation (ASCT). Previous case reports have showed persistence of renal amyloid mass in light-chain amyloidosis (AL) even in the setting of hematologic and renal response. We report a novel finding in two cases of heavy- and light-chain amyloidosis (AHL) in which monoclonal Ig but not serum amyloid P (SAP), apolipoprotein E (ApoE) or amyloid bulk in the kidney regressed after successful therapy. In the pre-treatment renal biopsies, the amyloid deposits stained for one heavy and one light chains (IgG + λ in one case and IgA + κ in one case). Laser microdissection followed by mass spectrometry (LMD/MS) in both cases showed abundant spectra for Ig heavy and light chains, SAP and ApoE. Both patients achieved a hematologic response with disappearance of the monoclonal protein from serum and urine and normalization of serum-free light chain ratio, but renal response occurred in only one patient. Repeat kidney biopsies showed persistence of fibrillar amyloid deposits, but regression of Ig from the...Continue Reading

References

Aug 23, 1990·The New England Journal of Medicine·P N HawkinsM B Pepys
May 9, 1995·Proceedings of the National Academy of Sciences of the United States of America·G A TennentM B Pepys
Aug 1, 1998·Amyloid : the International Journal of Experimental and Clinical Investigation : the Official Journal of the International Society of Amyloidosis·S InoueR Kisilevsky
Jun 8, 2000·Amyloid : the International Journal of Experimental and Clinical Investigation : the Official Journal of the International Society of Amyloidosis·R Kisilevsky
Nov 8, 2003·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Martin ZeierHartmut Goldschmidt
Jul 16, 2005·Virchows Archiv : an International Journal of Pathology·Batia KaplanMordechai R Kramer
Oct 1, 2005·Amyloid : the International Journal of Experimental and Clinical Investigation : the Official Journal of the International Society of Amyloidosis·Sadayuki InoueShinichi Ohno
Jan 18, 2006·Annual Review of Medicine·Mark B Pepys
Feb 27, 2013·Clinical Nephrology·Hiroshi OkuyamaHitoshi Yokoyama
Aug 28, 2013·Nature Reviews. Nephrology·Julian D Gillmore, Philip N Hawkins
Nov 16, 2013·Amyloid : the International Journal of Experimental and Clinical Investigation : the Official Journal of the International Society of Amyloidosis·Masayuki MoriKeiichi Higuchi

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Citations

Oct 22, 2016·Current Problems in Cancer·Jason Kidd, Daniel E Carl
Jul 26, 2019·Amyloid : the International Journal of Experimental and Clinical Investigation : the Official Journal of the International Society of Amyloidosis·Yukihiro OtakaTakaaki Tsutsui
Oct 10, 2019·Amyloid : the International Journal of Experimental and Clinical Investigation : the Official Journal of the International Society of Amyloidosis·Avital Angel-KormanAndrea Havasi
Feb 9, 2019·The American Journal of Pathology·Tina RicheyJonathan S Wall

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