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The spectrum of kidney pathology in B-cell chronic lymphocytic leukemia / small lymphocytic lymphoma: a 25-year multicenter experience.

AbstractBACKGROUND:
Chronic lymphocytic leukemia and small lymphocytic lymphoma are 2 different presentations of the most common B-cell neoplasm in western countries (CLL/SLL). In this disease, kidney involvement is usually silent, and is rarely reported in the literature. This study provides a clinicopathological analysis of all-cause kidney disease in CLL/SLL patients.
METHODS:
Fifteen CLL/SLL patients with kidney biopsy were identified retrospectively. Demographic, clinical, pathological and laboratory data were assessed at biopsy, and during follow-up.
RESULTS:
At biopsy 11 patients presented impaired renal function, 7 patients nephrotic syndrome, 6 patients dysproteinemia, and 3 patients cryoglobulinemia. Kidney pathology revealed CLL/SLL-specific monoclonal infiltrate in 10 biopsies, glomerulopathy in 9 biopsies (5 membranoproliferative glomerulonephritis, 2 minimal change disease, 1 glomerulonephritis with organized microtubular monoclonal immunoglobulin deposits, 1 AHL amyloidosis). Five patients presented interstitial granulomas attributed to CLL/SLL. After treatment of the hematological disease, improvement of renal function was observed in 7/11 patients, and remission of nephrotic syndrome in 5/7 patients. During follow-up, aggravation of the kidney disease systematically occurred in the absence of favorable response to hematological treatment.
CONCLUSIONS:
A broad spectrum of kidney diseases is associated with CLL/SLL. In this setting, kidney biopsy can provide important information for diagnosis and therapeutic guidance.
AuthorsAnne-Laure Poitou-Verkinder, Arnaud Francois, Fanny Drieux, Stéphane Lepretre, Bruno Legallicier, Bruno Moulin, Michel Godin, Dominique Guerrot
JournalPloS one (PLoS One) Vol. 10 Issue 3 Pg. e0119156 ( 2015) ISSN: 1932-6203 [Electronic] United States
PMID25811382 (Publication Type: Journal Article, Multicenter Study)
Topics
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
  • Demography
  • Female
  • Follow-Up Studies
  • Glomerulonephritis (complications)
  • Humans
  • Kidney (diagnostic imaging, metabolism, pathology)
  • Leukemia, Lymphocytic, Chronic, B-Cell (drug therapy, metabolism, pathology)
  • Lymphocyte Count
  • Male
  • Middle Aged
  • Nephrotic Syndrome (complications)
  • Radiography
  • Recurrence
  • Retrospective Studies

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