No regression of renal AL amyloid in monoclonal gammopathy after successful autologous blood stem cell transplantation and significant clinical improvement
No regression of renal AL amyloid in monoclonal gammopathy after successful autologous blood stem cell transplantation and significant clinical improvement
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DOI：
10.1093/ndt/gfg436
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发表时间：
2003-12-01
影响因子：
6.1
通讯作者：
Goldschmidt, H
中科院分区：
文献类型：
--
作者：
Zeier, M;Perz, J;Goldschmidt, H
背景。高剂量化疗后进行自体造血干细胞移植可缓解 AL 淀粉样变性患者的浆细胞恶液质。这种治疗对肾小球淀粉样蛋白质量的影响尚不清楚。方法。在本研究中，评估了两名患者在大剂量马法兰治疗和自体造血干细胞移植之前和之后3年以上的肾淀粉样蛋白质量的数量。在第二次肾活检时，两名患者均处于完全缓解状态，未检测到血清和尿液单克隆 IgA-lambda，骨髓中浆细胞百分比正常。结果。在两名经活检证实患有 AL 淀粉样变性的患者中，尿蛋白排泄量从 7g/24h 下降至
Background. High-dose chemotherapy followed by autologous blood stem cell transplantation induces remission of plasma cell dyscrasia in patients with AL amyloidosis. The impact of this treatment on the glomerular amyloid mass is still unknown.Methods. In the present study, the quantity of the renal amyloid mass before and more than 3 years after high-dose melphalan treatment and autologous blood stem cell transplantation was assessed in two patients. At the time of the second renal biopsy, both patients were in complete remission without detectable serum and urinary monocloncal IgA-lambda and a normal percentage of plasma cells in the bone marrow.Results. In both patients with biopsy-proven AL amyloidosis, urinary protein excretion decreased from 7g/24h to