Bortezomib in chronic active antibody-mediated rejection: a single center experience
10.3760/cma.j.issn.0254-1785.2019.09.007
- VernacularTitle: 硼替佐米对慢性活动性抗体介导的排斥反应的治疗探索
- Author:
Xue LI
1
;
Jinsong CHEN
;
Dongrui CHENG
;
Kenan XIE
;
Xuefeng NI
;
Jiqiu WEN
;
Zheng TANG
Author Information
1. National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University, School of Medicine, Nanjing 210002, China
- Publication Type:Clinical Trail
- Keywords:
Kidney transplantation;
Graft rejection;
Prognosis;
Adverse reaction
- From:
Chinese Journal of Organ Transplantation
2019;40(9):539-544
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the efficacy and safety of bortezomib in kidney transplant recipients with chronic active antibody-mediated rejection (cABMR).
Methods:A retrospective study wad conducted in patients(n=136)fulfilling the Banff 2017 criteria for cABMR from January 2004 to July 2017, including 29 patients bortezomib group and 97 patients in control group. Identified cABMR patients were dichotomized into bortezomib and control groups with a 1∶1 match using the propensity score matching method. The primary outcome was initiation of replacement therapy or an estimated glomerular filtration rate(eGFR)declined to <15 ml·min-1·(1.73m2)-1. The prognosis and adverse reactions of two groups were analyzed and evaluated.
Results:No significant inter-group differences existed in age, sex ratio, immunosuppressive regimen, allograft age, serum creatinine, eGFR, urine protein, serum albumin, hemoglobin or HCV positive rate(all P>0.05). There were no significant inter-group differences in Banff scores (g, i, t, v, ah, mm, ci, ct, cv, ptc, c4d, all P>0.05). The median survival for bortezomib group and control group was 40.7 months and 36.9 months respectively. No statistically significant difference in graft survival between the two groups was observed(P=0.83), even after propensity score adjustment(P=0.29). The incidence of nausea, diarrhea and thrombocytopenia in bortezomib group was higher than those in control group (P<0.05).
Conclusions:Bortezomib does not seem to improve the prognosis of cABMR while is associated with higher incidence of adverse reactions.
