Long-term outcome of autologous stem cell transplantation in light chain deposition disease

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
Elizabeth C LorenzNelson Leung

Abstract

Light chain deposition disease (LCDD) is a systemic disorder characterized by deposition of non-amyloid monoclonal light chains. Renal dysfunction is a ubiquitous manifestation of the LCDD disease. Reports suggest that high-dose chemotherapy and autologous stem cell transplantation (ASCT) may be beneficial in the treatment of LCDD. However, the impact of ASCT on renal function is unclear. This study retrospectively reviewed the effect of ASCT on renal function in patients with LCDD. Six patients with LCDD have been transplanted at our institution since 2001. Patients received dexamethasone alone, dexamethasone plus thalidomide or no chemotherapy prior to conditioning. All the patients underwent high-dose melphalan conditioning after stem cell mobilization. Three of the six patients had concurrent multiple myeloma (MM), and one patient was on haemodialysis prior to transplantation. Four patients were male and two were female. The median age was 43.5 years with a median serum creatinine of 2.4 mg/dl and a median estimated glomerular filtration rate (eGFR) of 26.5 ml/min/1.73 m(2). Five patients survived ASCT and one died on Day 26 of transplantation. Median follow-up was 31.7 months (range 31.3-60.7 months) after ASCT. Of the sur...Continue Reading

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