Renal failure in a patient with chronic myelomonocytic leukaemia

Massive uric acid nephrolithiasis with progressive renal failure due to spontaneous tumour lysis syndrome

“…All risk factors for TLS described in patients undergoing induction therapy for AML were present [ 4 ]. Direct tumour cell infiltration of the kidney by CMML has been reported previously and was possibly responsible for the pre-existing chronic renal failure in our patient [ 8 ]. Rapid correction of obstructive uropathy was not successful in restoring kidney function in our patient, which was also the case in four out of five patients undergoing such a procedure in a recently published series [ 5 ].…”

A Forgotten Cause of Kidney Injury in Chronic Myelomonocytic Leukemia

“…CMML, a hybrid disorder characterized by overlap of myelodysplastic and myeloproliferative disorders,3 affects predominantly elderly patients 4. The disorder affects kidneys through infiltration of monocytes in glomeruli,1,5 amyloid deposition, 6 production of tumor necrosis factor α,7 and, rarely, increased production and excretion of lysozyme. The case presented here is an example of the latter entity, in which overproduction of lysozyme, an enzyme stored in myelomonocytic cells, is released into the circulation, filtered by glomeruli, and taken up by tubular cells.…”

An unexpected complication of chronic myelomonocytic leukemia: severe renal failure due to malignant tubulo-interstitial cell infiltration

“…3 Intrinsic renal involvement, though uncommon, is more likely to be encountered in CMML than in other forms of myelodysplasia. 4 The scarce reports of biopsy-proven CMML-associated renal dysfunction mostly describe extracapillary or membranous glomerulonephritis and amyloid deposition. Proposed mechanisms underlying CMML-related glomerular impingement are abnormal antigen presentation, aberrant interactions between B-and T-cells, or production of high levels of circulating immune complexes or pro-inflammatory cytokines (eg, TNF-alpha) by activated monocytic cells.…”

“…Only two similar cases were previously published. 4,9 Treatment of ATIN aims at controlling the underlying disease and/or eradicating the inciting agent. 8 Since no Allogeneic stem cell transplantation offers the best chance for long-term remission but remains controversial due to the lack of efficacy studies and the high comorbidity of an often elderly CMML population.…”