High-dose melphalan and autologous hematopoietic stem cell transplant in patient with C3 glomerulonephritis associated with monoclonal gammopathy

There is currently no standard treatment for monoclonal immunoglobulin (MIg)-associated C3 glomerulopathy, and treatment is often dictated by the extent of the monoclonal gammopathy. Although chemotherapy treatment for MIg-associated C3 glomerulopathy may stabilize renal function, the overall renal prognosis of MIgassociated C3 glomerulopathy is still poor with frequent progression to end-stage renal disease. We present a case of a 55-year-old man with IgG-? gammopathy-associated C3 glomerulonephritis (C3GN) with bone marrow biopsy demonstrating 5 - 10 ?-restricted plasma cells. Following chemotherapy treatment unfortunately, the patient encountered relapsing courses of the disease. The patient subsequently received high-dose melphalan treatment followed by autologous hematopoietic stem cell transplant (ASCT). At 8 months follow-up, the patient remained hematologic response with stable kidney function. Since ASCT can offer durable hematologic remission, ASCT can potentially be a curative treatment option for patients with MIg-associated C3GN.