Membranous nephropathy associated with donor lymphocyte infusion following allogeneic bone marrow transplantation
Nephrotic syndrome after hematopoietic stem cell transplantation (HSCT) followed by donor lymphocyte infusion (DLI) has never been described. We report the case of a myelodysplastic syndrome (MDS) patient who developed nephrotic syndrome with membranous nephropathy 18 months after allogeneic HSCT an...
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Veröffentlicht in: | International journal of hematology 2003-10, Vol.78 (3), p.262-265 |
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container_title | International journal of hematology |
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creator | MIYAZAKI, Yasuhiko MORI, Yasukiyo KISHIMOTO, Noriko MATSUMOTO, Noriaki ZEN, Katsuhiro AMAKAWA, Ryuichi KISHIMOTO, Yuji FUKUHARA, Shirou |
description | Nephrotic syndrome after hematopoietic stem cell transplantation (HSCT) followed by donor lymphocyte infusion (DLI) has never been described. We report the case of a myelodysplastic syndrome (MDS) patient who developed nephrotic syndrome with membranous nephropathy 18 months after allogeneic HSCT and 4 months after DLI. A 50-year-old woman with MDS underwent allogeneic bone marrow transplantation from her HLA-matched brother. MDS relapsed 55 days after transplantation, donor lymphocytes were infused as adoptive immunotherapy, and complete remission was achieved. Four months after the third DLI, the patient developed nephrotic syndrome with proteinuria up to 9 g/day. Renal biopsy revealed granular deposits of immunoglobulin G along the glomerular basement membrane, and subepithelial electron-dense deposits. A diagnosis of membranous nephropathy was made. For maintenance of the immunotherapeutic effect of DLI, minimum doses of immunosuppressive therapy for decreasing proteinuria were administered, and improvement of nephrotic syndrome and persistent complete remission of MDS were achieved. |
doi_str_mv | 10.1007/BF02983805 |
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We report the case of a myelodysplastic syndrome (MDS) patient who developed nephrotic syndrome with membranous nephropathy 18 months after allogeneic HSCT and 4 months after DLI. A 50-year-old woman with MDS underwent allogeneic bone marrow transplantation from her HLA-matched brother. MDS relapsed 55 days after transplantation, donor lymphocytes were infused as adoptive immunotherapy, and complete remission was achieved. Four months after the third DLI, the patient developed nephrotic syndrome with proteinuria up to 9 g/day. Renal biopsy revealed granular deposits of immunoglobulin G along the glomerular basement membrane, and subepithelial electron-dense deposits. A diagnosis of membranous nephropathy was made. For maintenance of the immunotherapeutic effect of DLI, minimum doses of immunosuppressive therapy for decreasing proteinuria were administered, and improvement of nephrotic syndrome and persistent complete remission of MDS were achieved.</description><identifier>ISSN: 0925-5710</identifier><identifier>EISSN: 1865-3774</identifier><identifier>DOI: 10.1007/BF02983805</identifier><identifier>PMID: 14604287</identifier><language>eng</language><publisher>Tokyo: Springer</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Biological and medical sciences ; Bone Marrow Transplantation - adverse effects ; Bone marrow, stem cells transplantation. Graft versus host reaction ; Female ; Glomerulonephritis ; Glomerulonephritis, Membranous - drug therapy ; Glomerulonephritis, Membranous - etiology ; Humans ; Lymphocyte Transfusion - adverse effects ; Medical sciences ; Middle Aged ; Myelodysplastic Syndromes - complications ; Myelodysplastic Syndromes - therapy ; Nephrology. Urinary tract diseases ; Nephropathies. Renovascular diseases. Renal failure ; Nephrotic Syndrome - drug therapy ; Nephrotic Syndrome - etiology ; Proteinuria - drug therapy ; Proteinuria - etiology ; Remission Induction ; Transfusions. Complications. Transfusion reactions. Cell and gene therapy ; Transplantation, Homologous</subject><ispartof>International journal of hematology, 2003-10, Vol.78 (3), p.262-265</ispartof><rights>The Japanese Society of Hematology 2003</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c393t-d954e9f22197df44c4fa52baadd67f0dfe9027456db4cc05e3f7af0273a07c1c3</citedby><cites>FETCH-LOGICAL-c393t-d954e9f22197df44c4fa52baadd67f0dfe9027456db4cc05e3f7af0273a07c1c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=15439761$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/14604287$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>MIYAZAKI, Yasuhiko</creatorcontrib><creatorcontrib>MORI, Yasukiyo</creatorcontrib><creatorcontrib>KISHIMOTO, Noriko</creatorcontrib><creatorcontrib>MATSUMOTO, Noriaki</creatorcontrib><creatorcontrib>ZEN, Katsuhiro</creatorcontrib><creatorcontrib>AMAKAWA, Ryuichi</creatorcontrib><creatorcontrib>KISHIMOTO, Yuji</creatorcontrib><creatorcontrib>FUKUHARA, Shirou</creatorcontrib><title>Membranous nephropathy associated with donor lymphocyte infusion following allogeneic bone marrow transplantation</title><title>International journal of hematology</title><addtitle>Int J Hematol</addtitle><description>Nephrotic syndrome after hematopoietic stem cell transplantation (HSCT) followed by donor lymphocyte infusion (DLI) has never been described. We report the case of a myelodysplastic syndrome (MDS) patient who developed nephrotic syndrome with membranous nephropathy 18 months after allogeneic HSCT and 4 months after DLI. A 50-year-old woman with MDS underwent allogeneic bone marrow transplantation from her HLA-matched brother. MDS relapsed 55 days after transplantation, donor lymphocytes were infused as adoptive immunotherapy, and complete remission was achieved. Four months after the third DLI, the patient developed nephrotic syndrome with proteinuria up to 9 g/day. Renal biopsy revealed granular deposits of immunoglobulin G along the glomerular basement membrane, and subepithelial electron-dense deposits. A diagnosis of membranous nephropathy was made. For maintenance of the immunotherapeutic effect of DLI, minimum doses of immunosuppressive therapy for decreasing proteinuria were administered, and improvement of nephrotic syndrome and persistent complete remission of MDS were achieved.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Biological and medical sciences</subject><subject>Bone Marrow Transplantation - adverse effects</subject><subject>Bone marrow, stem cells transplantation. Graft versus host reaction</subject><subject>Female</subject><subject>Glomerulonephritis</subject><subject>Glomerulonephritis, Membranous - drug therapy</subject><subject>Glomerulonephritis, Membranous - etiology</subject><subject>Humans</subject><subject>Lymphocyte Transfusion - adverse effects</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myelodysplastic Syndromes - complications</subject><subject>Myelodysplastic Syndromes - therapy</subject><subject>Nephrology. Urinary tract diseases</subject><subject>Nephropathies. Renovascular diseases. Renal failure</subject><subject>Nephrotic Syndrome - drug therapy</subject><subject>Nephrotic Syndrome - etiology</subject><subject>Proteinuria - drug therapy</subject><subject>Proteinuria - etiology</subject><subject>Remission Induction</subject><subject>Transfusions. Complications. Transfusion reactions. 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Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Biological and medical sciences</topic><topic>Bone Marrow Transplantation - adverse effects</topic><topic>Bone marrow, stem cells transplantation. Graft versus host reaction</topic><topic>Female</topic><topic>Glomerulonephritis</topic><topic>Glomerulonephritis, Membranous - drug therapy</topic><topic>Glomerulonephritis, Membranous - etiology</topic><topic>Humans</topic><topic>Lymphocyte Transfusion - adverse effects</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myelodysplastic Syndromes - complications</topic><topic>Myelodysplastic Syndromes - therapy</topic><topic>Nephrology. Urinary tract diseases</topic><topic>Nephropathies. Renovascular diseases. Renal failure</topic><topic>Nephrotic Syndrome - drug therapy</topic><topic>Nephrotic Syndrome - etiology</topic><topic>Proteinuria - drug therapy</topic><topic>Proteinuria - etiology</topic><topic>Remission Induction</topic><topic>Transfusions. Complications. Transfusion reactions. 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We report the case of a myelodysplastic syndrome (MDS) patient who developed nephrotic syndrome with membranous nephropathy 18 months after allogeneic HSCT and 4 months after DLI. A 50-year-old woman with MDS underwent allogeneic bone marrow transplantation from her HLA-matched brother. MDS relapsed 55 days after transplantation, donor lymphocytes were infused as adoptive immunotherapy, and complete remission was achieved. Four months after the third DLI, the patient developed nephrotic syndrome with proteinuria up to 9 g/day. Renal biopsy revealed granular deposits of immunoglobulin G along the glomerular basement membrane, and subepithelial electron-dense deposits. A diagnosis of membranous nephropathy was made. For maintenance of the immunotherapeutic effect of DLI, minimum doses of immunosuppressive therapy for decreasing proteinuria were administered, and improvement of nephrotic syndrome and persistent complete remission of MDS were achieved.</abstract><cop>Tokyo</cop><pub>Springer</pub><pmid>14604287</pmid><doi>10.1007/BF02983805</doi><tpages>4</tpages></addata></record> |
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subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Biological and medical sciences Bone Marrow Transplantation - adverse effects Bone marrow, stem cells transplantation. Graft versus host reaction Female Glomerulonephritis Glomerulonephritis, Membranous - drug therapy Glomerulonephritis, Membranous - etiology Humans Lymphocyte Transfusion - adverse effects Medical sciences Middle Aged Myelodysplastic Syndromes - complications Myelodysplastic Syndromes - therapy Nephrology. Urinary tract diseases Nephropathies. Renovascular diseases. Renal failure Nephrotic Syndrome - drug therapy Nephrotic Syndrome - etiology Proteinuria - drug therapy Proteinuria - etiology Remission Induction Transfusions. Complications. Transfusion reactions. Cell and gene therapy Transplantation, Homologous |
title | Membranous nephropathy associated with donor lymphocyte infusion following allogeneic bone marrow transplantation |
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