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Successful kidney transplantation in a patient with pre-existing chronic myeloid leukemia treated with imatinib.
Am J Transplant. 2020 Jul 12 [Online ahead of print]AJ

Abstract

Active malignancy is an absolute contraindication to kidney transplantation. As for chronic myeloid leukemia (CML), a Philadelphia chromosome-positive myeloproliferative neoplasm, the introduction of tyrosine kinase inhibitors has transformed CML from a lethal into a manageable chronic disease with a close-to-normal life expectancy. To date it is unknown whether kidney transplantation can be safely performed in patients with pre-existing CML. We describe the clinical course of a 57-year-old male patient with chronic kidney disease caused by reflux nephropathy. This patient had undergone first kidney transplantation 20 years earlier and had again been on chronic hemodialysis for 6 years when CML was diagnosed. First-line therapy with 400 mg imatinib daily was well tolerated and induced an optimal cytogenetic and molecular response 3 months after initiation. One and a half years after CML diagnosis, a second kidney transplantation from a deceased donor was performed. Immunosuppression included basiliximab, tacrolimus, mycophenolate mofetil, and corticosteroids. Currently, 2 years posttransplant, renal allograft function is stable (serum creatinine 1.09 mg/dL, estimated glomerular filtration rate 75 mL/min per 1.73 m2), and CML remains in deep molecular remission with imatinib. Imatinib-treated CML in deep molecular remission could be regarded as inactive malignancy and may therefore not be viewed as an absolute contraindication to kidney transplantation.

Authors+Show Affiliations

Department of Nephrology and Hypertension Diseases, Transplantation Medicine and Rheumatology, Ordensklinikum Linz, Krankenhaus Elisabethinen, Linz, Austria. Faculty of Medicine, Johannes Kepler University Linz, Linz, Austria.Department of Internal Medicine I: Hematology with Stem Cell Transplantation, Hemostaseology and Medical Oncology, Ordensklinikum Linz, Krankenhaus Elisabethinen, Linz, Austria.Laboratory for Molecular Biology and Tumor Cytogenetics, Department of Internal Medicine I, Ordensklinikum Linz, Barmherzige Schwestern, Linz, Austria.Laboratory for Molecular Biology and Tumor Cytogenetics, Department of Internal Medicine I, Ordensklinikum Linz, Barmherzige Schwestern, Linz, Austria.Department of Nephrology and Hypertension Diseases, Transplantation Medicine and Rheumatology, Ordensklinikum Linz, Krankenhaus Elisabethinen, Linz, Austria.Department of Nephrology and Hypertension Diseases, Transplantation Medicine and Rheumatology, Ordensklinikum Linz, Krankenhaus Elisabethinen, Linz, Austria.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32654389

Citation

Thiem, Ursula, et al. "Successful Kidney Transplantation in a Patient With Pre-existing Chronic Myeloid Leukemia Treated With Imatinib." American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons, 2020.
Thiem U, Buxhofer-Ausch V, Kranewitter W, et al. Successful kidney transplantation in a patient with pre-existing chronic myeloid leukemia treated with imatinib. Am J Transplant. 2020.
Thiem, U., Buxhofer-Ausch, V., Kranewitter, W., Webersinke, G., Enkner, W., & Cejka, D. (2020). Successful kidney transplantation in a patient with pre-existing chronic myeloid leukemia treated with imatinib. American Journal of Transplantation : Official Journal of the American Society of Transplantation and the American Society of Transplant Surgeons. https://doi.org/10.1111/ajt.16194
Thiem U, et al. Successful Kidney Transplantation in a Patient With Pre-existing Chronic Myeloid Leukemia Treated With Imatinib. Am J Transplant. 2020 Jul 12; PubMed PMID: 32654389.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Successful kidney transplantation in a patient with pre-existing chronic myeloid leukemia treated with imatinib. AU - Thiem,Ursula, AU - Buxhofer-Ausch,Veronika, AU - Kranewitter,Wolfgang, AU - Webersinke,Gerald, AU - Enkner,Wolfgang, AU - Cejka,Daniel, Y1 - 2020/07/12/ PY - 2020/01/28/received PY - 2020/05/29/revised PY - 2020/06/28/accepted PY - 2020/7/13/pubmed PY - 2020/7/13/medline PY - 2020/7/13/entrez KW - cancer/malignancy/neoplasia: hematogenous/leukemia/lymphoma KW - clinical decision-making KW - clinical research/practice KW - hematology/oncology KW - kidney disease KW - kidney transplantation/nephrology KW - retransplantation JF - American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons JO - Am. J. Transplant. N2 - Active malignancy is an absolute contraindication to kidney transplantation. As for chronic myeloid leukemia (CML), a Philadelphia chromosome-positive myeloproliferative neoplasm, the introduction of tyrosine kinase inhibitors has transformed CML from a lethal into a manageable chronic disease with a close-to-normal life expectancy. To date it is unknown whether kidney transplantation can be safely performed in patients with pre-existing CML. We describe the clinical course of a 57-year-old male patient with chronic kidney disease caused by reflux nephropathy. This patient had undergone first kidney transplantation 20 years earlier and had again been on chronic hemodialysis for 6 years when CML was diagnosed. First-line therapy with 400 mg imatinib daily was well tolerated and induced an optimal cytogenetic and molecular response 3 months after initiation. One and a half years after CML diagnosis, a second kidney transplantation from a deceased donor was performed. Immunosuppression included basiliximab, tacrolimus, mycophenolate mofetil, and corticosteroids. Currently, 2 years posttransplant, renal allograft function is stable (serum creatinine 1.09 mg/dL, estimated glomerular filtration rate 75 mL/min per 1.73 m2), and CML remains in deep molecular remission with imatinib. Imatinib-treated CML in deep molecular remission could be regarded as inactive malignancy and may therefore not be viewed as an absolute contraindication to kidney transplantation. SN - 1600-6143 UR - https://www.unboundmedicine.com/medline/citation/32654389/Successful_kidney_transplantation_in_a_patient_with_pre-existing_chronic_myeloid_leukemia_treated_with_imatinib L2 - https://doi.org/10.1111/ajt.16194 DB - PRIME DP - Unbound Medicine ER -
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