Long-term reversibility of renal dysfunction associated to light chain deposition disease with bortezomib and dexamethasone and high dose therapy and autologous stem cell transplantation

  • Tomás J. González-López | tomasgonlop@usal.es Hematology Department, University Hospital of Salamanca, Salamanca, Spain.
  • Lourdes Vázquez Hematology Department, University Hospital of Salamanca, Salamanca, Spain.
  • Teresa Flores Pathology Service, University Hospital of Salamanca, Salamanca, Spain.
  • Jesus Fernando San Miguel Hematology Department, University Hospital of Salamanca, Salamanca, Spain.
  • Ramon García-Sanz Hematology Department, University Hospital of Salamanca, Salamanca, Spain.

Abstract

A 63-year-old woman presented with progressive renal insufficiency, until a glomerular filtration rate (GFR) of 12 mL/min. A renal biopsy demonstrated glomerular deposition of immunoglobulin k light chain. The presence of a small population of monoclonal plasmacytes producing an only light k monoclonal component was demonstrated and Bortezomib and Dexamethasone (BD) was provided as initial therapy. After seven courses of therapy, renal function improved without dialysis requirements up to a GFR 31 mL/min. Under hematological complete response (HCR) the patient underwent high dose of melphalan (HDM) and autologous peripheral blood stem cell transplant. Fifty-four months later the patient remains in HCR and the GFR has progressively improved up to 48 mL/min. This report describes a notably renal function improvement in a patient with Light Chain Deposition Disease after therapy with BD followed by HDM, which can support this treatment as a future option for these patients.

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Author Biographies

Tomás J. González-López, Hematology Department, University Hospital of Salamanca, Salamanca
Consultant. Hematology.
Lourdes Vázquez, Hematology Department, University Hospital of Salamanca, Salamanca
Consultant. Hematology.
Teresa Flores, Pathology Service, University Hospital of Salamanca, Salamanca
Consultant. Pathology.
Jesus Fernando San Miguel, Hematology Department, University Hospital of Salamanca, Salamanca
Service Chief. Hematology.
Ramon García-Sanz, Hematology Department, University Hospital of Salamanca, Salamanca
Consultant. Hematology.
Published
2011-11-23
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Issue
Section
Case Reports
Keywords:
light chain deposition disease, free light chain, monoclonal gammopathy, bortezomib, transplant.
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How to Cite
González-López, T. J., Vázquez, L., Flores, T., San Miguel, J. F., & García-Sanz, R. (2011). Long-term reversibility of renal dysfunction associated to light chain deposition disease with bortezomib and dexamethasone and high dose therapy and autologous stem cell transplantation. Clinics and Practice, 1(4), e95. https://doi.org/10.4081/cp.2011.e95