High-dose melphalan and auto-SCT in patients with monoclonal Ig deposition disease

H. Hassoun, C. Flombaum, V. D. D'Agati, B. T. Rafferty, A. Cohen, V. M. Klimek, A. Boruchov, T. Kewalramani, L. Reich, Stephen D Nimer, R. L. Comenzo

Research output: Contribution to journalArticle

53 Citations (Scopus)

Abstract

The treatment of monoclonal Ig deposition disease (MIDD) is controversial and not standardized. We report our experience with high dose melphalan and auto-SCT (HDM/auto-SCT) in seven patients with MIDD associated with underlying Durie-Salmon stage IB multiple myeloma, including five with light chain deposition disease, one with light and heavy chain deposition disease and one with light chain crystal deposition disease. The median age of these patients was 50 years; six of them were male subjects. A monoclonal κ-light chain was detected by Serum Free Light Chain Assay in all seven. The patients received melphalan 140 mg/m2 followed by auto-SCT. All patients are alive and six remain in hematologic CR with a median follow up of 23.6 months (7.9-69.8 months). Renal function has improved compared to pre-HDSM/auto-SCT in five patients - two of whom had a renal transplant and became dialysis independent - remained stable in one and worsened in one leading to hemodialysis despite hematologic CR. Our results corroborate previous experience with HDM/auto-SCT in MIDD and argue in favor of kidney transplantation in patients who achieve hematologic CR after HDM/auto-SCT. Although this approach appears effective, multi-center studies are needed to define the optimal treatment for patients with MIDD.

Original languageEnglish
Pages (from-to)405-412
Number of pages8
JournalBone Marrow Transplantation
Volume42
Issue number6
DOIs
StatePublished - Jul 22 2008
Externally publishedYes

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Melphalan
Light
Heavy Chain Disease
Kidney
Salmon
Multiple Myeloma
Kidney Transplantation
Renal Dialysis
Dialysis
Transplants
Therapeutics
Serum

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Hassoun, H., Flombaum, C., D'Agati, V. D., Rafferty, B. T., Cohen, A., Klimek, V. M., ... Comenzo, R. L. (2008). High-dose melphalan and auto-SCT in patients with monoclonal Ig deposition disease. Bone Marrow Transplantation, 42(6), 405-412. https://doi.org/10.1038/bmt.2008.179

High-dose melphalan and auto-SCT in patients with monoclonal Ig deposition disease. / Hassoun, H.; Flombaum, C.; D'Agati, V. D.; Rafferty, B. T.; Cohen, A.; Klimek, V. M.; Boruchov, A.; Kewalramani, T.; Reich, L.; Nimer, Stephen D; Comenzo, R. L.

In: Bone Marrow Transplantation, Vol. 42, No. 6, 22.07.2008, p. 405-412.

Research output: Contribution to journalArticle

Hassoun, H, Flombaum, C, D'Agati, VD, Rafferty, BT, Cohen, A, Klimek, VM, Boruchov, A, Kewalramani, T, Reich, L, Nimer, SD & Comenzo, RL 2008, 'High-dose melphalan and auto-SCT in patients with monoclonal Ig deposition disease', Bone Marrow Transplantation, vol. 42, no. 6, pp. 405-412. https://doi.org/10.1038/bmt.2008.179
Hassoun H, Flombaum C, D'Agati VD, Rafferty BT, Cohen A, Klimek VM et al. High-dose melphalan and auto-SCT in patients with monoclonal Ig deposition disease. Bone Marrow Transplantation. 2008 Jul 22;42(6):405-412. https://doi.org/10.1038/bmt.2008.179
Hassoun, H. ; Flombaum, C. ; D'Agati, V. D. ; Rafferty, B. T. ; Cohen, A. ; Klimek, V. M. ; Boruchov, A. ; Kewalramani, T. ; Reich, L. ; Nimer, Stephen D ; Comenzo, R. L. / High-dose melphalan and auto-SCT in patients with monoclonal Ig deposition disease. In: Bone Marrow Transplantation. 2008 ; Vol. 42, No. 6. pp. 405-412.
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