The Spectrum of Kidney Pathology in B-Cell Chronic Lymphocytic Leukemia / Small Lymphocytic Lymphoma: A 25-Year Multicenter Experience
Open Access
- 26 March 2015
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 10 (3), e0119156
- https://doi.org/10.1371/journal.pone.0119156
Abstract
Chronic lymphocytic leukemia and small lymphocytic lymphoma are 2 different presentations of the most common B-cell neoplasm in western countries (CLL/SLL). In this disease, kidney involvement is usually silent, and is rarely reported in the literature. This study provides a clinicopathological analysis of all-cause kidney disease in CLL/SLL patients. Fifteen CLL/SLL patients with kidney biopsy were identified retrospectively. Demographic, clinical, pathological and laboratory data were assessed at biopsy, and during follow-up. At biopsy 11 patients presented impaired renal function, 7 patients nephrotic syndrome, 6 patients dysproteinemia, and 3 patients cryoglobulinemia. Kidney pathology revealed CLL/SLL-specific monoclonal infiltrate in 10 biopsies, glomerulopathy in 9 biopsies (5 membranoproliferative glomerulonephritis, 2 minimal change disease, 1 glomerulonephritis with organized microtubular monoclonal immunoglobulin deposits, 1 AHL amyloidosis). Five patients presented interstitial granulomas attributed to CLL/SLL. After treatment of the hematological disease, improvement of renal function was observed in 7/11 patients, and remission of nephrotic syndrome in 5/7 patients. During follow-up, aggravation of the kidney disease systematically occurred in the absence of favorable response to hematological treatment. A broad spectrum of kidney diseases is associated with CLL/SLL. In this setting, kidney biopsy can provide important information for diagnosis and therapeutic guidance.Keywords
This publication has 52 references indexed in Scilit:
- Renal AmyloidosisClinical Journal of the American Society of Nephrology, 2013
- Onco-NephrologyClinical Journal of the American Society of Nephrology, 2012
- Infiltration du parenchyme rénal par une leucémie lymphoïde chronique B à différenciation plasmocytaire et insuffisance rénale : une éventualité rare en néphropathologie. Revue de la littérature à propos d’un casNephrologie & Therapeutique, 2011
- Concurrent nephrotic syndrome and acute renal failure caused by chronic lymphocytic leukemia (CLL): a case report and literature reviewDiagnostic Pathology, 2011
- Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute–Working Group 1996 guidelinesBlood, 2008
- Acute Kidney Injury Network: report of an initiative to improve outcomes in acute kidney injuryCritical Care, 2007
- AL amyloidosis associated with B‐cell lymphoproliferative disorders: Frequency and treatment outcomesAmerican Journal of Hematology, 2006
- Minimal Change Glomerulonephritis in Chronic Lymphocytic Leukemia: Pathophysiological and Therapeutic AspectsOncology Research and Treatment, 2006
- Granulomatous reactions cause symptoms or clinically imitate treatment resistance in small lymphocytic lymphoma/chronic lymphocytic leukaemia more frequently than in other non-Hodgkin lymphomasJournal of Clinical Pathology, 2005
- Fibrillar glomerulopathy associated with chronic lymphocytic leukaemiaNephrology Dialysis Transplantation, 1996