The Management of Membranous Glomerulopathy in Allogeneic Stem Cells Transplantation: Updated Literature

Abstract

BACKGROUND:

membranous glomerulopathy (MG) is an immunomediated disorder which accounts for the most common cause of nephrotic syndrome (NS) following allogeneic hematopoietic stem cell transplantation (HSCT).

OBJECTIVE AND METHODS:

to provide an update on the issue by reviewing pertinent literature on the MEDLINE database.

RESULTS:

sixty-nine post allogenic HSCT patients (42 male) with MG were identified. The median age was 43 (5 to 68) years. Time interval from allogenic HSCT to MG diagnosis ranged from 3 to 134 months (median 17). Most MG patients had a history of acute (70%) or chronic (84%) graft versus host disease (GVHD). Corticosteroids and cyclosporine were the most common therapeutic agents used in this setting; alternative therapies, including rituximab, were given to a lower number of patients. Outcome data were available in 64 out of 69 MG patients; 38 (59%) and 18 (28%) patients achieved a complete and a partial response respectively, whereas treatment failure was recorded in the remaining 8 (13%).

CONCLUSION:

MG after allogenic HSCT appears to be associated with a sub clinical or overt cGVHD, which follows the discontinuation of immunosuppressive prophylaxis. Although a standard therapeutic approach has not been established, the application of available measures can induce favorable response in more than 80% of affected patients, but treatment-failure and progressive deterioration of the renal function may occur in about one fifth of cases.

• Authors: Pasquale Niscola, Andrea Tendas, Xiao-dan Luo, Gianfranco Catalano, Laura Scaramucci, Luca Cupelli, Marco Giovannini, Michele Ferrannini, Francesco Bondanini, Daniela Piccioni, Teresa Dentamaro, Roberto Palumbo, Alessio Pio Perrotti, Qi-fa Liu, Paolo de Fabritiis
• Journal: Cardiovascular & hematological agents in medicinal chemistry (Cardiovasc Hematol Agents Med Chem) Vol. 11 Issue 1 Pg. 67-76 (03 2013) ISSN: 1875-6182 [Electronic] Netherlands
• PMID: 23016546 (Publication Type: Journal Article, Review)

Topics

• Glomerulonephritis, Membranous (diagnosis, drug therapy, epidemiology, etiology)
• Hematopoietic Stem Cell Transplantation (adverse effects)
• Humans
• Risk Factors
• Transplantation, Homologous (adverse effects)