It is unclear if immunosuppression will increase the chance of malignant transformation of monoclonal gammopathy of undetermined significance (MGUS) and whether or not antagonistic renal outcomes in kidney transplant recipients with MGUS are extra frequent.
We carried out a retrospective cohort research of kidney transplant recipients on the Centre Hospitalier de l’Université de Montréal between 2000 and 2016.Among 755 research individuals, 13 (1.7%) have been discovered to have MGUS earlier than transplant. Two developed to smoldering a number of myeloma and a pair of offered paraprotein-induced allograft harm from gentle chain deposition illness.
Forty-six sufferers developed posttransplant MGUS (2.5% 5-y cumulative incidence) of which 1 progressed to a number of myeloma and 1 skilled kidney allograft loss from gentle chain deposition illness. None of the sufferers with a malignant transformation or paraprotein-induced renal illness after transplantation had had a scientific workup earlier than transplantation to exclude hematologic malignancies and paraprotein-related kidney harm.
Nine posttransplant MGUS (21%) have been transient. Multivariable evaluation revealed that age at transplant (hazard ratio 1.05 per 1-y enhance, 95% confidence intervals, 1.02-1.08) and prior cytomegalovirus an infection (hazard ratio 2.22, 95% confidence intervals, 1.07-4.58) have been related to the event of MGUS after transplantation. Of 7 posttransplant lymphoproliferative issues, none have been preceded by MGUS.
Our outcomes recommend that the identification of MGUS in a transplant candidate ought to result in additional investigations to exclude a plasma cell neoplasm and monoclonal gammopathy of renal significance earlier than transplantation. MGUS arising after transplantation seems to hold a good evolution.