Patients with plasma cell dyscrasias, including multiple myeloma, AL amyloidosis, and monoclonal gammopathy of renal significance, face a high burden of end-stage kidney disease, which limits survival and quality of life. Although kidney transplantation offers potential benefits, it remains underused because of the high risk of recurrence and historically poor outcomes. A multidisciplinary panel of transplant nephrologists, hematologists/oncologists, and pathologists convened to evaluate contemporary evidence and evolving strategies in kidney transplant for plasma cell dyscrasias and end-stage kidney disease.
Transforming the lives of people with cancer and organ transplants through integrated healthcare and research.
Watch intro video (4 min)
The Center for Innovations in Cancer & Transplant was founded with the following goals:
- To provide outstanding multidisciplinary clinical care for pre- and post-transplant patients with cancer.
- To lead exceptional, multidimensional, patient-focused research of cancer before and after organ transplant through a robust bioregistry and collaborative research network.
We seek to do this through a first-of-its kind clinic, a new bioregistry, and our own original research.
Learn more about the Center
Clinic
The first-of-its-kind multidisciplinary consult clinic for organ transplant candidates and recipients with cancer.
Bioregistry
A registry to integrate patient data from cancer centers and transplant programs around the world.
Research
Investigating the immune mechanisms and epidemiology of cancer with solid organ transplantation.
Recent publications
Management recommendations for kidney transplantation in patients with plasma cell dyscrasia
Naoka Murakami, Christopher D. Blosser…Heather Landau
Kidney International
Original Work
DOI: 10.1016/j.kint.2025.07.011
Advances in plasma cell dyscrasia therapies are improving survival and expanding kidney transplant eligibility. However, key challenges remain, including optimizing hematologic response pre–kidney transplant and managing immunosuppression to mitigate recurrence and avoid infection complications. Ongoing research and multidisciplinary collaboration are essential to refine transplant selection, integrate biomarkers for risk stratification, and develop tailored post–kidney transplant surveillance. These efforts may increase access to kidney transplant and improve outcomes for patients with plasma cell dyscrasias and end-stage kidney disease.
Real-world evidence regarding cancer, mortality, and graft failure risk with de novo belatacept use among kidney transplant recipients in the United States
Shyfuddin Ahmed…Christopher D. Blosser…Eric A. Engels
American Journal of Transplantation
Original Work
DOI: 10.1016/j.ajt.2025.03.004
Belatacept is a selective T-cell co-stimulation blocker used in maintenance immunosuppression for kidney transplant recipients (KTRs), but evidence on cancer risk and other outcomes is limited. This retrospective cohort study used linked US transplant and cancer registry data on KTRs treated with belatacept (N=1514) or tacrolimus (N=7570) as initial maintenance therapy.
We used multivariable Cox regression models to compare incidence of invasive cancer, cutaneous squamous cell carcinoma (cSCC), posttransplant lymphoproliferative disorder (PTLD), death, and graft failure/retransplantation (GF/RT) between belatacept and tacrolimus users. Overall, cancer incidence was 10.1 and 12.6 per 1000 person-years in belatacept and tacrolimus users, respectively. We did not find increased risk with belatacept for cancer overall (adjusted hazard ratio [HR] 0.83, 95% confidence interval [95%CI] 0.53-1.30), individual cancer types, or cSCC. Belatacept was associated with increased risk of death (adjusted HR 1.22, 95%CI 1.04-1.43) but lower risk of GF/RT more than four years after transplantation (0.54, 0.35-0.83). PTLD risk was increased among EBV-seropositive KTRs (adjusted HR 1.96, 95%CI 1.03-3.73). This study provides reassurance that belatacept does not increase cancer risk among KTRs, and there was a long-term protective association for GF/RT. However, we found evidence suggesting a potential increased risk of PTLD and death with belatacept use.
PTLD – It’s Best to Face This Growing Challenge at the Start
Christopher D. Blosser, Lianna J. Marks, Vikas R. Dharnidharka
American Journal of Transplantation
Editorial
DOI: 10.1016/j.ajt.2025.03.006
Post-transplant lymphoproliferative disorder (PTLD) is a leading cancer cause of death in kidney transplant recipients (KTRs). Understanding the risk factors that predispose KTRs to PTLD is a crucial step in developing strategies to mitigate this serious complication and improve patient outcomes.