Department of Hematology and Hemotherapy, Hospital Universitario Nuestra Señora de la Candelaria, Santa Cruz de Tenerife, Spain.
Nephrology (Carlton). 2013 Sep;18(9):641-3. doi: 10.1111/nep.12116.
Plasma cell dyscrasias (PCD) are a spectrum of diseases characterized by clonal proliferation of plasma cells secreting a monoclonal immunoglobulin. Although considered an incurable disease, a combination of autologous stem cell transplant with novel therapies, including lenalidomide, has improved the overall and progression-free survival of these patients. Renal impairment is an important complication of the disease that, in some cases, progresses to end-stage renal disease. Due to the characteristics of PCD, traditionally these patients have not been candidates for renal transplantation. However, treatment improvement allows a reconsideration of this perception, especially in younger patients with good performance status and treatment response. We report two cases of patients diagnosed with PCD undergoing renal transplantation after autologous stem cell transplantation, both cases under treatment with lenalidomide. We also report their perioperative management and their outcome.
浆细胞疾病（PCD）是一组以浆细胞克隆性增殖为特征的疾病，这些浆细胞分泌单克隆免疫球蛋白。虽然该病被认为是一种无法治愈的疾病，但自体干细胞移植与新型疗法（包括来那度胺）的联合应用改善了这些患者的总体生存率和无进展生存率。肾功能损害是该疾病的一个重要并发症，在某些情况下会进展为终末期肾病。由于 PCD 的特点，传统上这些患者不符合肾移植的条件。然而，治疗方法的改进允许重新考虑这种观点，特别是在年轻、身体状况良好且对治疗有反应的患者中。我们报告了两例接受自体干细胞移植后接受肾移植的 PCD 患者的病例，这两例患者均接受来那度胺治疗。我们还报告了他们的围手术期管理及其结果。
