The effect of bortezomib on antibody-mediated rejection after kidney transplantation

Juhan Lee, Beom Seok Kim, Yongjung Park, Jae Geun Lee, Beom Jin Lim, Hyeon Joo Jeong, Yu Seun Kim, Kyu Ha Huh

Research output: Contribution to journalArticle

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Abstract

Purpose: Recently, bortezomib has been used to treat antibody-mediated rejection (AMR) refractory to conventional treatment such as plasmapheresis, intravenous immunoglobulin, and rituximab. The authors aimed to describe their experiences when bortezomib was used to treat refractory AMR. Materials and Methods: Eleven refractory AMR episodes treated with bortezomib were included in this study. The patients received one or two cycles of bortezomib (1.3 mg/m2) on days 1, 4, 8, and 11. Results: Bortezomib effectively reduced antibodies against various targets, including human leukocyte antigen (HLA) class I and II, ABO blood group antigen, and angiotensin II type 1 receptor. Antibodies were depleted or reduced significantly in eight AMR episodes. Overall, there was a significant improvement in the mean estimated glomerular filtration rate (eGFR) at 3 months after therapy (36.91±22.15 mL/min/1.73 m2) versus eGFR at time of AMR diagnosis (17.00±9.25 mL/min/1.73 m2; p=0.007). All six early-onset AMR episodes (within 6 months post-transplantation) showed full recovery of allograft function. Additionally, three of the five late-onset AMR episodes (>6 months post-transplantation) showed improved allograft function. Conclusion: Anti-humoral treatment based on bortezomib might be an effective strategy against refractory AMR caused by various types of antibodies. Notably, this treatment could be more effective in early-onset AMR than in late-onset AMR.

Original languageEnglish
Pages (from-to)1638-1642
Number of pages5
JournalYonsei medical journal
Volume56
Issue number6
DOIs
Publication statusPublished - 2015 Nov

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Kidney Transplantation
Antibodies
Glomerular Filtration Rate
Bortezomib
Allografts
Transplantation
Angiotensin Type 1 Receptor
Plasmapheresis
Intravenous Immunoglobulins
Recovery of Function
Therapeutics
Blood Group Antigens
HLA Antigens

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Lee, J., Kim, B. S., Park, Y., Lee, J. G., Lim, B. J., Jeong, H. J., ... Huh, K. H. (2015). The effect of bortezomib on antibody-mediated rejection after kidney transplantation. Yonsei medical journal, 56(6), 1638-1642. https://doi.org/10.3349/ymj.2015.56.6.1638
Lee, Juhan ; Kim, Beom Seok ; Park, Yongjung ; Lee, Jae Geun ; Lim, Beom Jin ; Jeong, Hyeon Joo ; Kim, Yu Seun ; Huh, Kyu Ha. / The effect of bortezomib on antibody-mediated rejection after kidney transplantation. In: Yonsei medical journal. 2015 ; Vol. 56, No. 6. pp. 1638-1642.
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abstract = "Purpose: Recently, bortezomib has been used to treat antibody-mediated rejection (AMR) refractory to conventional treatment such as plasmapheresis, intravenous immunoglobulin, and rituximab. The authors aimed to describe their experiences when bortezomib was used to treat refractory AMR. Materials and Methods: Eleven refractory AMR episodes treated with bortezomib were included in this study. The patients received one or two cycles of bortezomib (1.3 mg/m2) on days 1, 4, 8, and 11. Results: Bortezomib effectively reduced antibodies against various targets, including human leukocyte antigen (HLA) class I and II, ABO blood group antigen, and angiotensin II type 1 receptor. Antibodies were depleted or reduced significantly in eight AMR episodes. Overall, there was a significant improvement in the mean estimated glomerular filtration rate (eGFR) at 3 months after therapy (36.91±22.15 mL/min/1.73 m2) versus eGFR at time of AMR diagnosis (17.00±9.25 mL/min/1.73 m2; p=0.007). All six early-onset AMR episodes (within 6 months post-transplantation) showed full recovery of allograft function. Additionally, three of the five late-onset AMR episodes (>6 months post-transplantation) showed improved allograft function. Conclusion: Anti-humoral treatment based on bortezomib might be an effective strategy against refractory AMR caused by various types of antibodies. Notably, this treatment could be more effective in early-onset AMR than in late-onset AMR.",
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Lee, J, Kim, BS, Park, Y, Lee, JG, Lim, BJ, Jeong, HJ, Kim, YS & Huh, KH 2015, 'The effect of bortezomib on antibody-mediated rejection after kidney transplantation', Yonsei medical journal, vol. 56, no. 6, pp. 1638-1642. https://doi.org/10.3349/ymj.2015.56.6.1638

The effect of bortezomib on antibody-mediated rejection after kidney transplantation. / Lee, Juhan; Kim, Beom Seok; Park, Yongjung; Lee, Jae Geun; Lim, Beom Jin; Jeong, Hyeon Joo; Kim, Yu Seun; Huh, Kyu Ha.

In: Yonsei medical journal, Vol. 56, No. 6, 11.2015, p. 1638-1642.

Research output: Contribution to journalArticle

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T1 - The effect of bortezomib on antibody-mediated rejection after kidney transplantation

AU - Lee, Juhan

AU - Kim, Beom Seok

AU - Park, Yongjung

AU - Lee, Jae Geun

AU - Lim, Beom Jin

AU - Jeong, Hyeon Joo

AU - Kim, Yu Seun

AU - Huh, Kyu Ha

PY - 2015/11

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N2 - Purpose: Recently, bortezomib has been used to treat antibody-mediated rejection (AMR) refractory to conventional treatment such as plasmapheresis, intravenous immunoglobulin, and rituximab. The authors aimed to describe their experiences when bortezomib was used to treat refractory AMR. Materials and Methods: Eleven refractory AMR episodes treated with bortezomib were included in this study. The patients received one or two cycles of bortezomib (1.3 mg/m2) on days 1, 4, 8, and 11. Results: Bortezomib effectively reduced antibodies against various targets, including human leukocyte antigen (HLA) class I and II, ABO blood group antigen, and angiotensin II type 1 receptor. Antibodies were depleted or reduced significantly in eight AMR episodes. Overall, there was a significant improvement in the mean estimated glomerular filtration rate (eGFR) at 3 months after therapy (36.91±22.15 mL/min/1.73 m2) versus eGFR at time of AMR diagnosis (17.00±9.25 mL/min/1.73 m2; p=0.007). All six early-onset AMR episodes (within 6 months post-transplantation) showed full recovery of allograft function. Additionally, three of the five late-onset AMR episodes (>6 months post-transplantation) showed improved allograft function. Conclusion: Anti-humoral treatment based on bortezomib might be an effective strategy against refractory AMR caused by various types of antibodies. Notably, this treatment could be more effective in early-onset AMR than in late-onset AMR.

AB - Purpose: Recently, bortezomib has been used to treat antibody-mediated rejection (AMR) refractory to conventional treatment such as plasmapheresis, intravenous immunoglobulin, and rituximab. The authors aimed to describe their experiences when bortezomib was used to treat refractory AMR. Materials and Methods: Eleven refractory AMR episodes treated with bortezomib were included in this study. The patients received one or two cycles of bortezomib (1.3 mg/m2) on days 1, 4, 8, and 11. Results: Bortezomib effectively reduced antibodies against various targets, including human leukocyte antigen (HLA) class I and II, ABO blood group antigen, and angiotensin II type 1 receptor. Antibodies were depleted or reduced significantly in eight AMR episodes. Overall, there was a significant improvement in the mean estimated glomerular filtration rate (eGFR) at 3 months after therapy (36.91±22.15 mL/min/1.73 m2) versus eGFR at time of AMR diagnosis (17.00±9.25 mL/min/1.73 m2; p=0.007). All six early-onset AMR episodes (within 6 months post-transplantation) showed full recovery of allograft function. Additionally, three of the five late-onset AMR episodes (>6 months post-transplantation) showed improved allograft function. Conclusion: Anti-humoral treatment based on bortezomib might be an effective strategy against refractory AMR caused by various types of antibodies. Notably, this treatment could be more effective in early-onset AMR than in late-onset AMR.

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