Can We Cure Light Chain Deposition Disease of the Kidneys?-A Review and Case Report of a Patient Treated With a Triple Transplant Approach.

Renal involvement is ubiquitous in light chain deposition disease (LCDD) and often progresses to irreversible end-stage renal disease (ESRD). Currently, no guidelines outlining the treatment of patients with ESRD requiring hemodialysis secondary to LCDD have been accepted. A dual approach combining autologous stem cell transplantation (SCT) with renal transplantation has shown promising results in this population of patients. We performed a triple approach, combining autologous SCT, renal transplantation, and nonmyeloablative allogeneic SCT in a young woman with k-LCDD; she has remained in complete remission for > 9 years and has not required any immunosuppressive therapy. If complete hematologic remission is sustained in patients with LCDD with ESRD, renal transplant must be considered. The use of allogeneic SCT in this specific population of patients should be explored as a potentially curative option for those who have achieved remission in response to previous treatment. This triple approach treatment strategy could have a “curative role” in the treatment of patients with LCDD with ESRD requiring hemodialysis.