PMID- 36172352 OWN - NLM STAT- MEDLINE DCOM- 20220930 LR - 20221003 IS - 1664-3224 (Electronic) IS - 1664-3224 (Linking) VI - 13 DP - 2022 TI - Clinicopathological features and individualized treatment of kidney involvement in B-cell lymphoproliferative disorder. PG - 903315 LID - 10.3389/fimmu.2022.903315 [doi] LID - 903315 AB - BACKGROUND: Due to the various clinical and pathological manifestations of kidney involvement in lymphoproliferative disorder (LPD), the whole spectrum of kidney disease in LPD is still unclear, and data on kidney prognosis is scarce. METHODS: We retrospectively reviewed the renal pathology profiles from January 2010 to December 2021, and 28 patients with B-cell LPD combined with intact renal biopsy data were included. RESULTS: There were 20 men and eight women aging 41 to 79 years at the time of renal biopsy (median age 62 years). According to hematological diagnosis, patients were classified into four groups: chronic lymphocytic leukemia (CLL) (group1, n=7), Waldenstrom macroglobulinemia/lymphoplasmacytic lymphoma (WM/LPL) (group 2, n=8; WM, n=6; LPL, n=2), Other non-Hodgkin's lymphomas (NHL) (group3, n=7; diffuse large B-cell lymphoma (DLBCL), n=2; mucosa-associated lymphoid tissue (MALT) lymphoma, n=4; Low grade B-cell lymphoma, n=1), and monoclonal gammopathy of undetermined significance/monoclonal gammopathy of renal significance (MGUS/MGRS) (group 4, n=6). Median serum creatinine (Scr) level was 129 (range,59-956) umol/L. Eight patients (29%) were presented with acute kidney injury (AKI), and five patients (18%) required hemodialysis upon admission. Twenty-three patients (82%) presented with proteinuria (median protein excretion, 2.14 g/d), 11(39%) of whom had the nephrotic syndrome. Interstitial malignant infiltration was the most frequent renal lesion (n=6). Eight patients underwent immunohistochemistry of renal tissues, of which three patients (CLL, n=1; LPL, n=1; WM, n=1) had confirmed lymphoma infiltrates, and the infiltrating cells in the remaining five patients (CLL, n=1; MALT lymphoma, n=2; MGUS, n=2) were considered unrelated to lymphoma. The most common glomerular diseases were renal amyloidosis (n=4) and membranous nephropathy (n=4). Only 20 patients were treated, 13 of whom were treated with rituximab separately or in combination. The median follow-up time was 11 months. Of these, six had achieved hematological response, complete response in five cases. Eight had achieved renal response. At the end-of-study visit, four patients died and two progressed to end stage kidney disease (ESKD). CONCLUSION: In conclusion, the clinicopathological spectrum of renal involvement in BLPD is diverse. Renal biopsy and immunohistochemistry are required for early diagnosis and prognostic assessment. CI - Copyright (c) 2022 Nie, Sun, Zhang, Yuan, Mao, Wang, Li, Duan, Xing and Zhang. FAU - Nie, Guangyan AU - Nie G AD - Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China. FAU - Sun, Lianqin AU - Sun L AD - Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China. FAU - Zhang, Chengning AU - Zhang C AD - Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China. FAU - Yuan, Yanggang AU - Yuan Y AD - Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China. FAU - Mao, Huijuan AU - Mao H AD - Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China. FAU - Wang, Zhen AU - Wang Z AD - Department of Pathology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China. FAU - Li, Jianyong AU - Li J AD - Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, China. FAU - Duan, Suyan AU - Duan S AD - Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China. FAU - Xing, Changying AU - Xing C AD - Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China. FAU - Zhang, Bo AU - Zhang B AD - Department of Nephrology, the First Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, China. AD - Department of Nephrology, Pukou Branch of JiangSu Province Hospital (Nanjing Pukou Central Hospital), Nanjing, China. LA - eng PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20220912 PL - Switzerland TA - Front Immunol JT - Frontiers in immunology JID - 101560960 RN - 4F4X42SYQ6 (Rituximab) RN - AYI8EX34EU (Creatinine) SB - IM MH - *Acute Kidney Injury/pathology MH - Creatinine MH - Female MH - Humans MH - Kidney/pathology MH - *Leukemia, Lymphocytic, Chronic, B-Cell MH - *Leukocyte Disorders MH - *Lymphoma, B-Cell, Marginal Zone MH - *Lymphoproliferative Disorders/therapy MH - Male MH - Middle Aged MH - *Monoclonal Gammopathy of Undetermined Significance MH - Retrospective Studies MH - Rituximab/therapeutic use MH - *Waldenstrom Macroglobulinemia/pathology/therapy PMC - PMC9510618 OTO - NOTNLM OT - Waldenstrom macroglobulinemia/lymphoplasmacytoid lymphoma OT - chronic lymphocytic leukemia OT - kidney involvement OT - lymphoproliferative disorders OT - monoclonal gammopathy of undetermined significance OT - non-Hodgkin's lymphomas COIS- The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. EDAT- 2022/09/30 06:00 MHDA- 2022/10/01 06:00 PMCR- 2022/01/01 CRDT- 2022/09/29 02:17 PHST- 2022/03/24 00:00 [received] PHST- 2022/08/22 00:00 [accepted] PHST- 2022/09/29 02:17 [entrez] PHST- 2022/09/30 06:00 [pubmed] PHST- 2022/10/01 06:00 [medline] PHST- 2022/01/01 00:00 [pmc-release] AID - 10.3389/fimmu.2022.903315 [doi] PST - epublish SO - Front Immunol. 2022 Sep 12;13:903315. doi: 10.3389/fimmu.2022.903315. eCollection 2022.