Clinicopathological spectrum of renal parenchymal involvement in B-cell lymphoproliferative disorders

Javaugue, Vincent; Debiais‐Delpech, Celine; Nouvier, Mathilde; Gand, Elise; Chauvet, Sophie; Écotière, Laure; Desport, Éstelle; Goujon, Jean-Michel; Delwail, Vincent; Guidez, Stéphanie; Tomowiak, Cécile; Leleu, Xavier; Jaccard, Arnaud; Vigneau, Cécile; Fermand, Jean‐Paul; Touchard, Guy; Thierry, Antoine; Bridoux, Frank

doi:10.1016/j.kint.2019.01.027

Cited by 19 publications

(20 citation statements)

References 39 publications

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“…[1][2][3] Therefore, even if the prevalence of ITG remains low in CLL/SLL patients, it should be suspected in those exhibiting heavy albuminuria or nephrotic syndrome. [27][28][29] By contrast, ITG is exceptionally encountered in the setting of symptomatic multiple myeloma. 3 In our series, 70% of patients had detectable monoclonal gammopathy by immunofixation, a frequency close to that of 67% and 63% reported by Rosenstock et al and Nasr et al, respectively.…”

Section: Discussionmentioning

confidence: 99%

Results of a nation-wide cohort study suggest favorable long-term outcomes of clone-targeted chemotherapy in immunotactoid glomerulopathy

Javaugue¹,

Dufour-Nourigat²,

Desport³

et al. 2021

Kidney International

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Section: Discussionmentioning

confidence: 99%

Results of a nation-wide cohort study suggest favorable long-term outcomes of clone-targeted chemotherapy in immunotactoid glomerulopathy

Javaugue¹,

Dufour-Nourigat²,

Desport³

et al. 2021

Kidney International

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“…3 Another series from France (11 CLL patients) demonstrated similar results with approximately 45% having monoclonal protein-related lesions (1 Cryo GN, 1 LCCN, 2 immunotactoid glomerulopathy, and 1 PGNMID). 4 Other monoclonal protein-related lesions are described in Table 2. CLL infiltration is the second most common lesion revealed from kidney biopsies, and frequently coexists with other renal lesions.…”

Section: Discussionmentioning

confidence: 99%

Chronic lymphocytic leukemia and light chain proximal tubulopathy: A rare presentation of a common disease

Klomjit

Zand

Grande

et al. 2022

Journal of Onco-Nephrology

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Chronic lymphocytic leukemia (CLL) is the most common leukemia in developed countries. Kidney injuries related to CLL can occur via several mechanisms. Approximately 30%–40% of CLL patients with a kidney biopsy have monoclonal-protein related lesions. However, such lesions mostly involve glomeruli with only rare instances of tubule-interstitial disorders. There is only a single case report of a CLL patient who presented with crystalline light chain proximal tubulopathy (LCPT). Fanconi syndrome (FS) may provide clinical clues in these patients. We report a case of a CLL patient who presented with hypokalemia in the setting of advanced kidney failure in which serum monoclonal IgG kappa was detected. The patient demonstrated typical signs and symptoms of FS. The urinary retinol binding protein was also extremely elevated (638 times upper normal limit). A kidney biopsy revealed non-crystalline LCPT with CLL infiltration. FS in CLL is an extremely rare presentation, as only four cases had been previously reported. Of these, only a single case had crystalline LCPT. Our case is the first report of non-crystalline LCPT in a CLL patient. Obinutuzumab and Venetoclax were started to address the CLL, and an improvement in kidney function was noted thereafter.

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“…Recently, a study reported that among patients with B-cell lymphoproliferative disorders and kidney lymphoma infiltration, AKI was common. 17 This observation raises the concern that CAR T-cell therapy might damage the kidney by recognizing kidney tissue–resident B cells. In our case, we did not observe B-cell infiltration in the kidney on a kidney biopsy performed 3 weeks after CAR T-cell therapy infusion.…”

Section: Discussionmentioning

confidence: 99%

Acute Kidney Injury Following Chimeric Antigen Receptor T-Cell Therapy for B-Cell Lymphoma in a Kidney Transplant Recipient

et al. 2021

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Anti-CD19 chimeric antigen receptor (CAR) T-cell therapy is a newer and effective therapeutic option approved for patients with relapsed/refractory acute lymphoblastic leukemia and diffuse large B-cell lymphoma. Acute kidney injury is a complication of CAR T-cell therapy that can result in kidney failure. In most cases, it is thought to be related to hemodynamic changes due to cytokine release syndrome. Kidney biopsy in this clinical scenario is usually not performed. We report on a kidney transplant recipient in his 40s who developed a posttransplant lymphoproliferative disorder of B-cell origin refractory to conventional treatments and received anti-CD19 CAR T-cell therapy as compassionate treatment. Beginning on day 12 after CAR T-cell infusion, in the absence of clinical symptoms, a progressive decline in estimated glomerular filtration rate of the kidney graft occurred. A subsequent allograft biopsy showed mild tubulointerstitial lymphocyte infiltrates, falling into a Banff borderline-changes category and resembling an acute immunoallergic tubulointerstitial nephritis. Neither CAR T cells nor lymphomatous B cells were detected within the graft cellular infiltrates, suggesting an indirect mechanism of kidney injury. Although kidney graft function partially recovered after steroid therapy, the posttransplant lymphoproliferative disorder progressed and the patient died 7 months later.

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Clinicopathological spectrum of renal parenchymal involvement in B-cell lymphoproliferative disorders

Abstract: l'amylose AL et des autres maladies à dépôt d'immunoglobulines monoclonale

Cited by 19 publications

References 39 publications

Results of a nation-wide cohort study suggest favorable long-term outcomes of clone-targeted chemotherapy in immunotactoid glomerulopathy

Results of a nation-wide cohort study suggest favorable long-term outcomes of clone-targeted chemotherapy in immunotactoid glomerulopathy

Chronic lymphocytic leukemia and light chain proximal tubulopathy: A rare presentation of a common disease

Acute Kidney Injury Following Chimeric Antigen Receptor T-Cell Therapy for B-Cell Lymphoma in a Kidney Transplant Recipient

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