Early Renal Involvement in Acute Lymphoblastic Leukemia and Nonhodgkin’s Lymphoma in Children

Gilboa, Nisan; Lum, Gary; Urizar, Rodrigo E.

doi:10.1016/s0022-5347(17)52099-6

Cited by 23 publications

(11 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…8,10 Case Report The frequency of nephromegaly in ALL patients is variable; they have been reported to be between 2% and 24%. 3,8,11,12 Two etiologies of nephromegaly have been described: the first one is renal infiltration, which is more frequent in advanced stages of the disease, 5,8,13 and it has been found in up to 50% of autopsies in pediatric patients. 14 The second is hypertrophy or hyperplasia of parenchymal cells.…”

Section: Discussionmentioning

confidence: 99%

Renal Involvement at Diagnosis of Pediatric Acute Lymphoblastic Leukemia

et al. 2020

View full text Add to dashboard Cite

Acute leukemia is the most common type of cancer in pediatric patients. This type of cancer accounts for a third of all childhood cancer cases. More than half of pediatric acute leukemia patients show signs and symptoms such as hepatomegaly, splenomegaly, pallor, fever and bruising at the time of diagnosis. In early stages of acute lymphoblastic leukemia (ALL), nephromegaly and other renal manifestations such as high blood pressure (HBP) and renal failure are uncommon, although renal infiltration and nephromegaly are common in advanced-stage pediatric patients. This is a retrospective case review with a critical appraisal of the existing evidence from the literature. We present a clinical case of a child with HBP associated with bilateral nephromegaly which resolved after chemotherapy treatment. This patient presented with HBP that required pharmacological treatment, likely owing to nephromegaly. All HBP secondary causes were rejected. Nephromegaly was resolved after chemotherapy treatment, and antihypertensive medication was discontinued. Nephromegaly and HBP are rare manifestations of ALL debut in pediatrics. The present case report illustrates this unusual combination and Suggests clinicians to consider malignancy as its causal factor, especially if the symptoms are accompanied by other suggestive extrarenal manifestations.

show abstract

Section: Discussionmentioning

confidence: 99%

Renal Involvement at Diagnosis of Pediatric Acute Lymphoblastic Leukemia

et al. 2020

View full text Add to dashboard Cite

show abstract

“…As pretreatment abdominal ultrasounds were neither the standard of care nor a required evaluation prior to enrollment on therapeutic protocols, we were not able to determine whether this infiltration contributed to the BP elevations seen in our patients. However, computed tomography, ultrasound, and pathologic evaluations during autopsy have documented tumor-cell infiltration in the kidneys of patients with newly diagnosed ALL or non-Hodgkin's lymphoma [7,16,17], and these cells may contribute to the overall presence of prechemotherapy HBP and HTN via urinary tract obstruction, contributions to metabolic abnormalities, and/or infection [17][18][19].…”

Section: Discussionmentioning

confidence: 99%

High blood pressure and hypertension in children with newly diagnosed acute leukemia and lymphoma

Louis

Butani

2008

Pediatr Nephrol

View full text Add to dashboard Cite

Little has been published on the rate of prehypertension (HBP) and hypertension (HTN) in children with hematologic malignancies. This study was preformed to determine the prevalence and predictors of HBP and HTN in newly diagnosed acute leukemia and lymphoma patients. Retrospectively, blood pressure (BP) values were followed from admission until normalization in 102 children. HBP and HTN were defined as either a systolic or diastolic value > or = the 90th and 95th percentile BP measurement, respectively. HBP and HTN were identified in 68.6% and 52.9% of children prior to chemotherapy and 78.4% and 67.3% postchemotherapy, respectively. Mean time to BP normalization was 54 days. Only ten children (15% of HTN patients) received antihypertensive therapy. Logistic regression determined that the only predictor for HBP and HTN was the estimated glomerular filtration rate (eGFR) at the time of admission -- every 10 ml/min per 1.73 m(2) increase led to a 16% and 14% decrease in the odds of postchemotherapy HBP (p = 0.02) and HTN (p = 0.03), respectively. A surprisingly high prevalence of BP abnormalities was identified and lower eGFR predicted HBP and HTN in children with newly diagnosed hematologic malignancies. Better recognition and serious consideration for treatment should be given to this cardiovascular abnormality.

show abstract

“…Acute renal failure and hematuria as a primary manifestation of acute leukemia are very rare. Acute renal failure is attributed to acute tubular necrosis, nephrotoxic drugs, urate nephropathy, gout, tumor lysis and malignant infiltration [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%