Table 2.
Renal transplantation outcomes in various MIDD cohorts
| Summary of data on renal transplantation | Mayo Clinic 200412 | UK cohort 201510 | Mayo Clinic 201611 | French cohort 20194 | BU cohort 2020 |
|---|---|---|---|---|---|
| Number of kidney transplant patients | 7 | 7 | 9 | 23 | 6 patients, 7 grafts |
| Study period | 1972–1999 | 2002–2015 | 1992–2014 | 1981–2015 | 1996–2017 |
| Type of hematologic treatment (no. of patients) | Mel-Pred (3) No treatment (4) |
ASCT (4 ) No treatment (3) |
PI (2) ASCT (5) Unknown chemotherapy (1) No treatment (1) |
N/A | Mel-Pred (2) ASCT (2) PI (2) |
| Hematologic response at time of kidney transplant (number of patients) | N/A | CR (3) Not treated (4) |
CR (7) Unknown (2) |
CR/VGPR (14) Not treated, diagnosed after MIDD was found in the graft (9) |
CR (2) VGPR (1) PR (1) NR (3) |
| Number of patients with renal recurrence | 5 | 2 | 3 | 4 of 14 previously treated 9 of 9 previously not diagnosed/treated |
4 (1 PR, 3 NR) |
| Time from kidney transplant to disease recurrence | 33.3 mo (range, 3–45 mo) | 1.6 and 1.9 yr | 2.8, 9 yr | 38 mo (range, 32.5–42 mo) in previously treated patients 32 mo (range, 23–42 mo) in previously untreated patients |
3.2 yr (range, 4 mo–3.8 yr) |
| Median overall survival | From kidney transplant: 6.1 yr (range, 4 mo–12.8 yr) | N/A | N/A | N/A | From diagnosis: 19.8 yr (range, 13.7–27.7 yr) |
| Graft survival | 37.3 mo | 3 grafts lost: 2 due to disease recurrence and 1 due to rejection 4 functioning grafts (0.8–9.7 yr from kidney transplantation) |
2 grafts lost to disease recurrence 6 patients re-treated for hematologic relapse, have functioning graft |
1 graft lost due to disease recurrence (5 yr post-transplantation) 4 grafts lost after MIDD diagnosis after kidney transplantation at 46 mo (range, 40–52.5 mo) 3 grafts loss due to death 16 functioning grafts after median follow-up of 89 mo (range, 35–163 mo) |
4 grafts lost: 2 due to disease recurrence (4 mo and 3.8 yr after transplantation) and 2 due to death (13 and 20.4 yr after transplantation) 3 functioning grafts (1.7–6.5 yr from kidney transplant) |
ASCT, autologous stem cell transplant; CR, complete response; Dexa, dexamethasone; Dx, diagnosis; Mel-Pred, melphalan-prednisone; MIDD, monoclonal Ig deposition disease; N/A, not applicable; NR, no response; PI, proteasome inhibitor, PR, partial response; VGPR, very good partial response.