A Diverse Spectrum of Immune Complex– and Complement-Mediated Kidney Diseases Is Associated With Mantle Cell Lymphoma

Nicole K. Andeen, Shahad Abdulameer, Vivek Charu, Jonathan E. Zuckerman, Megan Troxell, Neeraja Kambham, Charles E. Alpers, Behzad Najafian, Roberto F. Nicosia, Kelly D. Smith, Vanderlene L. Kung, Rupali S. Avasare, Anusha Vallurupalli, J. Ashley Jefferson, Douglas Hecox, Leah Swetnam, Michifumi Yamashita, Mercury Lin, Mei Lin Bissonnette, Shreeram AkileshJean Hou

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)568-579
Number of pages12
JournalKidney International Reports
Issue number3
StatePublished - Mar 2022


  • MGRS
  • Mantle cell lymphoma
  • glomerulonephritis
  • kidney biopsy
  • lymphoma
  • renal pathology

ASJC Scopus subject areas

  • Nephrology


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