Department of Cardiology, Advanced Heart Failure and Transplantation, Texas Heart Institute, Houston, TX.
Am J Transplant. 2013 Oct;13(10):2730-3. doi: 10.1111/ajt.12391. Epub 2013 Aug 5.
We describe a patient who underwent a successful heart and kidney transplant for light-chain amyloidosis. She had an excellent hematologic response to bortezomib/dexamethasone therapy. Follow-up therapy with lenalidomide was started, and the patient quickly had a fatal allograft rejection of the heart and kidney. We present evidence to support the theory that lenalidomide, a known immunomodulator, may have stimulated the immune system and precipitated the fatal rejection episode.
我们描述了一位成功接受心脏和肾脏联合移植治疗轻链淀粉样变性的患者。她对硼替佐米/地塞米松治疗有极好的血液学反应。随后开始用来那度胺进行维持治疗，患者迅速发生致命的心肾移植物排斥反应。我们提供的证据支持这样一种理论，即来那度胺是一种已知的免疫调节剂，可能刺激了免疫系统并引发了致命的排斥反应。
