Efficacy of bortezomib for reducing donor-specific antibodies in children and adolescents on a steroid minimization regimen

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

AMR is increasingly being recognized as an important cause of renal allograft injury, contributing to significant morbidity and graft loss. There are few controlled trials and no well-established treatment guidelines for AMR in renal transplant recipients. We retrospectively reviewed the outcome of four pediatric renal transplant recipients on a steroid minimization immunosuppression protocol treated with bortezomib for elevated DSA and acute AMR from 2012 to 2013. All patients received four doses of bortezomib 1.3 mg/m2 given on days one, four, eight, and 11. All patients also received other treatments prior to bortezomib, which may have included rituximab, methylprednisolone, plasmapheresis, and/or IVIg. While bortezomib in addition to other therapies significantly decreased DSA titers, DSA remained very elevated months after treatment. All four patients had immediate improvement or stabilization of renal function but one eventually lost her graft. There were no adverse events related to bortezomib six months after treatment.

Original languageEnglish (US)
Pages (from-to)463-468
Number of pages6
JournalPediatric Transplantation
Volume18
Issue number5
DOIs
StatePublished - 2014

Fingerprint

Steroids
Tissue Donors
Antibodies
Kidney
Transplants
Therapeutics
Plasmapheresis
Methylprednisolone
Immunosuppression
Allografts
Bortezomib
Guidelines
Pediatrics
Morbidity
Wounds and Injuries
Transplant Recipients

Keywords

  • adolescent
  • antibody-mediated rejection
  • bortezomib
  • children
  • kidney transplantation

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Transplantation
  • Medicine(all)

Cite this

@article{ee9733c9f9db4e2caf81db62044a60c1,
title = "Efficacy of bortezomib for reducing donor-specific antibodies in children and adolescents on a steroid minimization regimen",
abstract = "AMR is increasingly being recognized as an important cause of renal allograft injury, contributing to significant morbidity and graft loss. There are few controlled trials and no well-established treatment guidelines for AMR in renal transplant recipients. We retrospectively reviewed the outcome of four pediatric renal transplant recipients on a steroid minimization immunosuppression protocol treated with bortezomib for elevated DSA and acute AMR from 2012 to 2013. All patients received four doses of bortezomib 1.3 mg/m2 given on days one, four, eight, and 11. All patients also received other treatments prior to bortezomib, which may have included rituximab, methylprednisolone, plasmapheresis, and/or IVIg. While bortezomib in addition to other therapies significantly decreased DSA titers, DSA remained very elevated months after treatment. All four patients had immediate improvement or stabilization of renal function but one eventually lost her graft. There were no adverse events related to bortezomib six months after treatment.",
keywords = "adolescent, antibody-mediated rejection, bortezomib, children, kidney transplantation",
author = "Stephanie Nguyen and Gallay, {Brian J} and Lavjay Butani",
year = "2014",
doi = "10.1111/petr.12274",
language = "English (US)",
volume = "18",
pages = "463--468",
journal = "Pediatric Transplantation",
issn = "1397-3142",
publisher = "Wiley-Blackwell",
number = "5",

}

TY - JOUR

T1 - Efficacy of bortezomib for reducing donor-specific antibodies in children and adolescents on a steroid minimization regimen

AU - Nguyen, Stephanie

AU - Gallay, Brian J

AU - Butani, Lavjay

PY - 2014

Y1 - 2014

N2 - AMR is increasingly being recognized as an important cause of renal allograft injury, contributing to significant morbidity and graft loss. There are few controlled trials and no well-established treatment guidelines for AMR in renal transplant recipients. We retrospectively reviewed the outcome of four pediatric renal transplant recipients on a steroid minimization immunosuppression protocol treated with bortezomib for elevated DSA and acute AMR from 2012 to 2013. All patients received four doses of bortezomib 1.3 mg/m2 given on days one, four, eight, and 11. All patients also received other treatments prior to bortezomib, which may have included rituximab, methylprednisolone, plasmapheresis, and/or IVIg. While bortezomib in addition to other therapies significantly decreased DSA titers, DSA remained very elevated months after treatment. All four patients had immediate improvement or stabilization of renal function but one eventually lost her graft. There were no adverse events related to bortezomib six months after treatment.

AB - AMR is increasingly being recognized as an important cause of renal allograft injury, contributing to significant morbidity and graft loss. There are few controlled trials and no well-established treatment guidelines for AMR in renal transplant recipients. We retrospectively reviewed the outcome of four pediatric renal transplant recipients on a steroid minimization immunosuppression protocol treated with bortezomib for elevated DSA and acute AMR from 2012 to 2013. All patients received four doses of bortezomib 1.3 mg/m2 given on days one, four, eight, and 11. All patients also received other treatments prior to bortezomib, which may have included rituximab, methylprednisolone, plasmapheresis, and/or IVIg. While bortezomib in addition to other therapies significantly decreased DSA titers, DSA remained very elevated months after treatment. All four patients had immediate improvement or stabilization of renal function but one eventually lost her graft. There were no adverse events related to bortezomib six months after treatment.

KW - adolescent

KW - antibody-mediated rejection

KW - bortezomib

KW - children

KW - kidney transplantation

UR - http://www.scopus.com/inward/record.url?scp=84903999696&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84903999696&partnerID=8YFLogxK

U2 - 10.1111/petr.12274

DO - 10.1111/petr.12274

M3 - Article

C2 - 24814755

AN - SCOPUS:84903999696

VL - 18

SP - 463

EP - 468

JO - Pediatric Transplantation

JF - Pediatric Transplantation

SN - 1397-3142

IS - 5

ER -