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

Main Article Content

Tomás J. González-López *
Lourdes Vázquez
Teresa Flores
Jesus Fernando San Miguel
Ramon García-Sanz
(*) Corresponding Author:
Tomás J. González-López | tomasgonlop@usal.es

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.