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PLoS One. 2015 Mar 26;10(3):e0119156. doi: 10.1371/journal.pone.0119156. eCollection 2015.

The spectrum of kidney pathology in B-cell chronic lymphocytic leukemia / small lymphocytic lymphoma: a 25-year multicenter experience.

Author information

1
Service de Néphrologie, CHU Hôpitaux de Rouen, Rouen, France.
2
Service d'Anatomie Pathologique, CHU Hôpitaux de Rouen, Rouen, France.
3
Service d'Hématologie, Centre Henri Becquerel, Rouen, France.
4
Service de Néphrologie, CHU Hôpitaux de Strasbourg, Strasbourg, France.
5
Service de Néphrologie, CHU Hôpitaux de Rouen, Rouen, France; INSERM Unité 1096, Université de Médecine-Pharmacie de Rouen, Rouen, France.

Abstract

BACKGROUND:

Chronic lymphocytic leukemia and small lymphocytic lymphoma are 2 different presentations of the most common B-cell neoplasm in western countries (CLL/SLL). In this disease, kidney involvement is usually silent, and is rarely reported in the literature. This study provides a clinicopathological analysis of all-cause kidney disease in CLL/SLL patients.

METHODS:

Fifteen CLL/SLL patients with kidney biopsy were identified retrospectively. Demographic, clinical, pathological and laboratory data were assessed at biopsy, and during follow-up.

RESULTS:

At biopsy 11 patients presented impaired renal function, 7 patients nephrotic syndrome, 6 patients dysproteinemia, and 3 patients cryoglobulinemia. Kidney pathology revealed CLL/SLL-specific monoclonal infiltrate in 10 biopsies, glomerulopathy in 9 biopsies (5 membranoproliferative glomerulonephritis, 2 minimal change disease, 1 glomerulonephritis with organized microtubular monoclonal immunoglobulin deposits, 1 AHL amyloidosis). Five patients presented interstitial granulomas attributed to CLL/SLL. After treatment of the hematological disease, improvement of renal function was observed in 7/11 patients, and remission of nephrotic syndrome in 5/7 patients. During follow-up, aggravation of the kidney disease systematically occurred in the absence of favorable response to hematological treatment.

CONCLUSIONS:

A broad spectrum of kidney diseases is associated with CLL/SLL. In this setting, kidney biopsy can provide important information for diagnosis and therapeutic guidance.

PMID:
25811382
PMCID:
PMC4374947
DOI:
10.1371/journal.pone.0119156
[Indexed for MEDLINE]
Free PMC Article

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