TY - JOUR
T1 - A Diverse Spectrum of Immune Complex– and Complement-Mediated Kidney Diseases Is Associated With Mantle Cell Lymphoma
AU - Andeen, Nicole K.
AU - Abdulameer, Shahad
AU - Charu, Vivek
AU - Zuckerman, Jonathan E.
AU - Troxell, Megan
AU - Kambham, Neeraja
AU - Alpers, Charles E.
AU - Najafian, Behzad
AU - Nicosia, Roberto F.
AU - Smith, Kelly D.
AU - Kung, Vanderlene L.
AU - Avasare, Rupali S.
AU - Vallurupalli, Anusha
AU - Jefferson, J. Ashley
AU - Hecox, Douglas
AU - Swetnam, Leah
AU - Yamashita, Michifumi
AU - Lin, Mercury
AU - Bissonnette, Mei Lin
AU - Akilesh, Shreeram
AU - Hou, Jean
N1 - Funding Information:
A portion of this work was presented in abstract form at ASN Kidney Week 2021. The authors thank Miguel Cardenas for his assistance in obtaining follow-up information.
Publisher Copyright:
© 2021 International Society of Nephrology
PY - 2022/3
Y1 - 2022/3
N2 - Introduction: There are limited reports on kidney biopsy findings in patients with mantle cell lymphoma (MCL). Methods: We initiated a multi-institutional, retrospective review of kidney biopsy findings in patients with active and treated MCL. Results: A total of 30 patients with MCL and kidney biopsies were identified, with a median age of 67 (range 48–87) years, 73% of whom were men. A total of 20 patients had active MCL at the time of biopsy, of whom 14 (70%) presented with acute kidney injury (AKI), proteinuria and/or hematuria, and biopsy findings potentially attributable to lymphoma. Of the 14, 11 had immune complex (IC) or complement-mediated (C3) disease including proliferative glomerulonephritis (GN) with monotypic Ig deposits (PGNMID [2]), C3GN, (2), secondary membranous nephropathy (MN [3]), tubular basement membrane (TBM) deposits (2), and modest lupus-like GN (2). Lymphomatous infiltration was present in 8 of the 20 patients, 5 with coincident IC or C3 lesions. A total of 6 patients with available follow-up were treated for MCL, all with clinical remission of GN (2 PGNMID, 2 C3GN, and 2 MN). Conclusion: MCL is associated with diverse monoclonal and polyclonal glomerular and extra-glomerular IC and C3 disease. For patients with active MCL and kidney dysfunction requiring biopsy, 70% had findings due or potentially due to lymphoma, including 55% with IC or C3 disease and 40% had lymphomatous kidney infiltration. IC and C3GN in the setting of active MCL was responsive to lymphoma-directed therapy.
AB - Introduction: There are limited reports on kidney biopsy findings in patients with mantle cell lymphoma (MCL). Methods: We initiated a multi-institutional, retrospective review of kidney biopsy findings in patients with active and treated MCL. Results: A total of 30 patients with MCL and kidney biopsies were identified, with a median age of 67 (range 48–87) years, 73% of whom were men. A total of 20 patients had active MCL at the time of biopsy, of whom 14 (70%) presented with acute kidney injury (AKI), proteinuria and/or hematuria, and biopsy findings potentially attributable to lymphoma. Of the 14, 11 had immune complex (IC) or complement-mediated (C3) disease including proliferative glomerulonephritis (GN) with monotypic Ig deposits (PGNMID [2]), C3GN, (2), secondary membranous nephropathy (MN [3]), tubular basement membrane (TBM) deposits (2), and modest lupus-like GN (2). Lymphomatous infiltration was present in 8 of the 20 patients, 5 with coincident IC or C3 lesions. A total of 6 patients with available follow-up were treated for MCL, all with clinical remission of GN (2 PGNMID, 2 C3GN, and 2 MN). Conclusion: MCL is associated with diverse monoclonal and polyclonal glomerular and extra-glomerular IC and C3 disease. For patients with active MCL and kidney dysfunction requiring biopsy, 70% had findings due or potentially due to lymphoma, including 55% with IC or C3 disease and 40% had lymphomatous kidney infiltration. IC and C3GN in the setting of active MCL was responsive to lymphoma-directed therapy.
KW - MGRS
KW - Mantle cell lymphoma
KW - glomerulonephritis
KW - kidney biopsy
KW - lymphoma
KW - renal pathology
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U2 - 10.1016/j.ekir.2021.12.020
DO - 10.1016/j.ekir.2021.12.020
M3 - Article
AN - SCOPUS:85122688646
SN - 2468-0249
VL - 7
SP - 568
EP - 579
JO - Kidney International Reports
JF - Kidney International Reports
IS - 3
ER -