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
Hauptverfasser: MIYAZAKI, Yasuhiko, MORI, Yasukiyo, KISHIMOTO, Noriko, MATSUMOTO, Noriaki, ZEN, Katsuhiro, AMAKAWA, Ryuichi, KISHIMOTO, Yuji, FUKUHARA, Shirou
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container_issue 3
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container_title International journal of hematology
container_volume 78
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. 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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><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. 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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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