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NDT Plus Advance Access published online on September 1, 2008
NDT Plus, doi:10.1093/ndtplus/sfn144
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© The Author [2008]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Pathologic improvement after high-dose melphalan and autologous stem cell transplantation for primary systemic amyloidosis

Junichi Hoshino1, Yoshifumi Ubara1, Kenichi Ohashi2, Fumi Takemoto1 and Kenmei Takaichi1

1 Nephrology Center
2 Department of Pathology, Toranomon Hospital, Tokyo, Japan

Correspondence: Junichi Hoshino, 2-2-2 Toranomon, Minato-ku, Tokyo 105-8470, Japan. Tel: +81-3-3588-1111; Fax: +81-3-3560-7785; E-mail: hoshino{at}toranomon.gr.jp


  Abstract

Although primary systemic amyloid light-chain amyloidosis was considered intractable, recent advances in therapy have been reported to result in better clinical outcomes including remission of nephrotic syndrome. However, changes in renal pathologic findings after high-dose chemo- therapy have not been characterized. We describe a patient who underwent serial renal biopsies and had complete remission after high-dose melphalan and autologous stem cell transplantation for this form of amyloidosis. Successive renal biopsy specimens showed reduction in amyloid staining mainly in interlobular arterial and arteriolar walls. Thus, amyloid light-chain amyloidosis resolved both clinically and pathologically after high-dose chemotherapy.

Key Words: AL amyloidosis • autologous stem cell transplantation • high-dose melphalan • pathologic improvement

Received for publication July 4, 2008. Accepted for publication August 7, 2008.


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