Renal failure and bone marrow transplantation

Coulibaly, N.; Hazzan, Marc; Noël-Walter, M P; Jouet, J P

doi:10.1093/ndt/13.10.2464

Cited by 47 publications

(31 citation statements)

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“…11 Whether the higher mortality in patients with ARF is directly caused by ARF or reflects pre-existing co-morbid complications, such as SOS and severe sepsis, remains unclear. 12 The aim of this retrospective study was to identify major risk factors for ARF at the time of transplantation and to identify post-transplantation complications that are associated with ARF. Second, we investigated whether the increased mortality in ARF patients is primarily due to ARF or is influenced by other associated complications.…”

Section: Introductionmentioning

confidence: 99%

Acute renal failure after allogeneic myeloablative stem cell transplantation: retrospective analysis of incidence, risk factors and survival

Kersting

Koomans

Hené

et al. 2007

Bone Marrow Transplant

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Section: Introductionmentioning

confidence: 99%

Acute renal failure after allogeneic myeloablative stem cell transplantation: retrospective analysis of incidence, risk factors and survival

Kersting

Koomans

Hené

et al. 2007

Bone Marrow Transplant

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“…30,31 Adverse effects of most chemotherapy regimens include nausea, vomiting and diarrhea, and HCT recipients frequently have volume depletion as a result of these gastrointestinal losses. Mucositis is another major complication of chemotherapy and poor oral fluid intake can result therefrom.…”

Section: Pathogenesismentioning

confidence: 99%

“…Acute tubular necrosis (ATN) 26,30,31 is also a common etiology of AKI in HCT patients and can ultimately overlap with prerenal azotemia due to volume depletion from dehydration (ischemic ATN) or sepsis (ischemic and/or nephrotoxic ATN). Patients can develop ischemic ATN in the context of hypovolemic or septic shock or nephrotoxic ATN as a result of drugs required for transplant, such as chemotherapy medication (cytarabine, carmustine, busulfan and fludarabine), antimicrobial agents (amphotericin B, aminoglycosides and vancomycin) and calcineurin inhibitors and methotrexate (MTX) used for GVHD prophylaxis and treatment.…”

Section: Pathogenesismentioning

confidence: 99%

Acute kidney injury in HCT: an update

Lopes

Jorge

Neves

2016

Bone Marrow Transplant

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Acute kidney injury (AKI) is highly prevalent whether the patients undergo myeloablative or non-myeloablative hematopoietic cell transplantation (HCT); however, the pathogenesis and risk factors leading to AKI can differ between the two. The prognosis of AKI in patients receiving HCT is poor. In fact, AKI following HCT is associated not only with increased short-and long-term mortality, but also with progression to chronic kidney disease. Herein, the authors provide a comprehensive and up-to-date review of the definition and diagnosis, as well as of the incidence, pathogenesis and outcome of AKI in patients undergoing HCT, centering on the differences between myeloablative and non-myeloablative regimens. INTRODUCTIONHematopoietic cell transplantation (HCT) is currently used to treat numerous malignant (for example, multiple myeloma, leukemias and lymphomas) and non-malignant hematological disorders (for example, aplastic anemia, b-thalassemia, immunodeficiency disorders and inborn errors of metabolism), as well as solid tumors (for example, breast cancer and neuroblastoma), which are in other instances incurable.The two major HCT procedures, taking into consideration the conditioning regimen used, are myeloablative autologous and allogeneic HCT and non-myeloablative allogeneic HCT. On the one hand, myeloablative HCT utilizes the maximally tolerated dose of TBI with or without chemotherapy, or with chemotherapy alone. On the other hand, non-myeloablative HCT depends more on donor cellular immune effects and less on the cytotoxic effects of the preparative regimen to control the underlying disease. 1,2 It ultimately uses a lower dose conditioning regimen and can thus be offered to older patients, to those debilitated by additional comorbidities, or to high-risk, heavily pretreated patients, who would not tolerate myeloablative HCT, resulting in a consequent decrease in regimen-related toxicity and treatment-related mortality. [3][4][5] Acute kidney injury (AKI) is highly prevalent whether the patients undergo myeloablative or non-myeloablative regimens; however, the pathogenesis and risk factors leading to AKI can differ between the two. In fact, AKI in patients receiving HCT is associated not only with increased short-and long-term mortality as compared with patients with no AKI, but also with a higher rate of progression to chronic kidney disease (CKD). Herein, the authors provide a comprehensive and up-to-date review of the definition and diagnosis of AKI as well as of the incidence, risk factors, pathogenesis and outcome of AKI in patients undergoing HCT, centering on the differences between myeloablative and nonmyeloablative regimens.

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“…2 As calcineurin inhibitors are part of the pathogenesis of TAM and are associated with RI, withdrawal may be desirable. [30][31][32] However, calcineurin inhibitors are a central part of GVHD prophylaxis and treatment and the latter is associated with TAM. Therefore, the positive effect of withdrawal of the calcineurin inhibitor is potentially offset by the subsequent progression of GVHD.…”

Section: Introductionmentioning

confidence: 99%

Replacement of calcineurin inhibitors with daclizumab in patients with transplantation-associated microangiopathy or renal insufficiency associated with graft-versus-host disease

Wolff

Wilhelm

Hahn

et al. 2006

Bone Marrow Transplant

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Transplantation-associated microangiopathy (TAM) or renal insufficiency (RI) after allogeneic hematopoietic stem cell transplantation is associated with a high mortality. As calcineurin inhibitors (CI) may contribute to TAM or RI, we evaluated the efficacy of replacing CI by daclizumab in patients with graft-versus-host disease (GVHD). Thirteen patients with GVHD-associated TAM and five patients with RI were treated with daclizumab 1 mg/kg intravenous (i.v.)/week, discontinuation of the CI and continuation of the remaining GVHD treatment. All patients had acute GVHD (steroid-sensitive (n ¼ 4), steroid-refractory (n ¼ 10)) or chronic GVHD (n ¼ 4) and were treated with CI before the start of daclizumab. Nine of 13 patients with TAM treated with daclizumab and discontinuation of CI achieved complete remission of TAM, two had stable disease, and one patient did not respond. Patients receiving daclizumab for RI without TAM showed stabilization (2/5) or improvement (3/5) of renal function. Four of 14 patients with acute GVHD achieved CR, two partial remission, eight patients did not respond and 11/14 died at a median of 39 days after start of the daclizumab. Our data demonstrate that replacement of CI by daclizumab can improve TAM and RI. However, mortality remains high in patients with acute GVHD.

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Renal failure and bone marrow transplantation

Cited by 47 publications

References 0 publications

Acute renal failure after allogeneic myeloablative stem cell transplantation: retrospective analysis of incidence, risk factors and survival

Acute renal failure after allogeneic myeloablative stem cell transplantation: retrospective analysis of incidence, risk factors and survival

Acute kidney injury in HCT: an update

Replacement of calcineurin inhibitors with daclizumab in patients with transplantation-associated microangiopathy or renal insufficiency associated with graft-versus-host disease

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