Bancu I, Cañas L, Juega F J, Pérez M, Malumbres S, Bonet J, Lauzurica R
Department of Nephrology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain.
Department of Nephrology, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; REDinREN 12/0021/0027, Spain.
Transplant Proc. 2015 Oct;47(8):2344-5. doi: 10.1016/j.transproceed.2015.08.023.
There are few reports about the clinical course and prognosis of monoclonal gammopathy of undetermined significance (MGUS) in long-term immunosuppressed patients. Our aim was to study the association and evolution of MGUS and renal transplantation.
Subjects submitted to renal transplantation between 1996 and 2011 who presented MGUS before or after immunosuppressive treatment was established were selected.
Patients (N = 587) underwent kidney transplantation in our center during the selected period. MGUS was detected in 17 (2.9%) patients (10 men and 7 women with a mean age of 69.9 ± 10.07 years), with a median follow-up of 6 years. All patients had a functioning graft. Nine had MGUS before transplantation. One patient had multiple myeloma, and 8 remained stable. Eight patients had development of MGUS after transplantation. Six patients remained stable, 1 showed no MGUS, and 1 displayed an increased monoclonal component in further controls.
In our study, renal transplantation is not a risk factor for the development of malignant processes in patients with MGUS before transplantation. There is a group of patients who tend to have MGUS after transplantation; nevertheless, they had a benign evolution during a 6-year follow-up.
关于长期免疫抑制患者意义未明的单克隆丙种球蛋白病(MGUS)的临床病程和预后的报道较少。我们的目的是研究MGUS与肾移植之间的关联及演变。
选取1996年至2011年间接受肾移植且在免疫抑制治疗确立之前或之后出现MGUS的患者。
在所选时间段内,有587例患者在我们中心接受了肾移植。17例(2.9%)患者检测出MGUS(10例男性和7例女性,平均年龄69.9±10.07岁),中位随访时间为6年。所有患者的移植肾均功能良好。9例患者在移植前患有MGUS。1例患者发展为多发性骨髓瘤,8例保持稳定。8例患者在移植后出现MGUS。6例患者保持稳定,1例未出现MGUS,1例在后续检查中显示单克隆成分增加。
在我们的研究中,肾移植并非移植前患有MGUS患者发生恶性病变的危险因素。有一组患者在移植后倾向于出现MGUS;然而,在6年的随访期间他们病情呈良性演变。