Mesangiolysis Associated With Bone Marrow Transplantation: New Insights on Possible Etiogenic Factors

Hébert, Marie‐Josée; Fish, Douglas; Madore, François; Bélanger, R; Nolin, Linda; Dandavino, R; Boucher, Anne; Marion, Alain

doi:10.1016/s0272-6386(12)80146-6

Cited by 9 publications

(4 citation statements)

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“…45,70 CY use may also be pathogenetically important, 71 and it is possible that infection is an initiating or contributing factor for thrombotic microangiopathy in HCT. 72 The most common clinical presentation is a subacute or chronic thrombotic microangiopathy that first becomes apparent 20 and 100 days after HCT.…”

Section: 41mentioning

confidence: 99%

Acute kidney injury following HCT: incidence, risk factors and outcome

Lopes

Jorge

2011

Bone Marrow Transplant

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Section: 41mentioning

confidence: 99%

Acute kidney injury following HCT: incidence, risk factors and outcome

Lopes

Jorge

2011

Bone Marrow Transplant

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“…In a study by Lonnerholm et al (53), carmustine, etoposide, cytarabine, and cyclophosphamide (BEAC) in conjunction with TBI uniformly resulted in renal insufficiency (eight of eight patients who received this regimen developed renal dysfunction) compared with zero of 14 adults who had diagnoses other than lymphoma and received TBI without BEAC. Hebert et al (54) described a case of a 40-yr-old woman who had Hodgkin's lymphoma and received two cycles of chemotherapy and then further conditioning chemotherapy before HCT but did not receive TBI. Her regimen was otherwise similar to that described above and included etoposide, cytarabine, and cisplatin.…”

Section: Thrombotic Microangiopathies: Thrombotic Thrombocytopenic Pumentioning

confidence: 99%

Chronic Kidney Disease in Long-Term Survivors of Hematopoietic Cell Transplantation

Hingorani

2006

Journal of the American Society of Nephrology

128

111

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High-dose myeloablative hematopoietic cell transplantation is becoming an increasingly common treatment modality for a variety of diseases. Patient survival may be limited by substantial treatment-related toxicities, including chronic kidney disease (CKD). Although the majority of CKD after transplantation is idiopathic, thrombotic microangiopathic syndromes and nephrotic syndrome have been described. Epidemiology, pathogenesis, and potential treatment options for the various clinical syndromes that are associated with CKD in hematopoietic cell transplantation patients is reviewed. As the indications for and the numbers of transplants that are performed worldwide increases, so will the burden of CKD. The nephrologists and oncologists will have to work together to identify patients who are at risk for CKD early to prevent its development and progression to end-stage kidney disease. 17: 199517: -200517: , 200617: . doi: 10.1681 H igh-dose myeloablative therapy followed by hematopoietic cell transplantation (HCT) is an increasingly common treatment for many malignancies and some genetic disorders. Approximately 20,000 HCTs now are performed annually worldwide and offer the prospect of cures for otherwise fatal or incurable diseases. The indications and applications for HCT are growing; for example, HCT now is considered for treatment of autoimmune diseases, Crohn's disease, and vasculitides that are refractory to other therapies (1,2). However, patient survival may be limited by substantial treatment-related toxicities. J Am Soc NephrolThis review focuses on chronic kidney disease (CKD) in survivors of HCT. For the nephrology consultant who deals with transplant survivors, it is important to be aware of the specific type of transplant and its complications to determine how best to treat the patient with renal injury secondary to thrombotic microangiopathy (TMA) syndromes, nephrotic syndrome (NS), persistent acute renal failure (ARF), and idiopathic CKD. Technique of HCTEach type of transplant carries its own risks and toxicities (Table 1). Autologous transplants involve the harvesting of a patient's own bone marrow or peripheral blood stem cells before high-dose myeloablative therapy, followed by re-infusion. Allogeneic transplants use bone marrow or peripheral blood stem cells from family members (ideally, HLA-matched siblings) or HLAmatched unrelated donors or stem cells from umbilical cord blood.Syngeneic transplants are from an identical twin donor. The infusion of stem cells is preceded by either myeloablative therapy (usually a combination of chemotherapy drugs or chemotherapy plus total body irradiation [TBI]) or nonmyeloablative (but immunosuppressive) therapy that allows host hematopoietic cells to coexist with donor stem cells to achieve mixed hematopoietic cell chimerism. The components of both myeloablative and nonmyeloablative conditioning regimens vary from center to center. The most common myeloablative regimens are cyclophosphamide plus TBI 10 to 14 Gy, busulfan plus cyclophosphamide, and busulf...

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“…This BMT nephropathy has also been called mesangiolysis comparable to a severe form of hemolytic uremic syndrome [112,113]. Since it involves diffuse endothelial damage, it may not only affect the kidney, but the liver and the lung as well.…”

Section: Bmt Nephropathymentioning

confidence: 99%

Renal involvement in children with malignancies

Rossi¹,

Kleta

Ehrich

1999

Pediatric Nephrology

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Renal complications in children with malignancies primarily arise from renal parenchymal tumors, "tumor lysis syndrome," and malignant infiltration or obstruction of the urinary tract. Therapy-associated renal side effects may develop following surgical and cytostatic treatment or be induced by radiotherapy. Clinically, both acute renal failure, for example following cisplatin, or chronic dysfunction, following ifosfamide and resulting in growth failure, are observed. Frequencies of renal impairment in these patients are, however, not well established, but terminal renal failure is a rare event: pediatric malignancies account for only 0.9% of patients on renal replacement therapy; the majority of these patients had been treated for a bilateral nephroblastoma. Since potentially serious long-term renal sequelae may evolve following both single measures and additive nephrotoxic effects, long-term monitoring of growth, blood pressure, and renal function is mandatory for a great proportion of former pediatric oncology patients. Future research should prospectively address frequencies of long-term renal impairment in these patients and should establish the prognosis of renal dysfunction. Only these data will ultimately allow risk-adopted use of potentially nephrotoxic treatment modalities and adequate counselling of patients.

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Mesangiolysis Associated With Bone Marrow Transplantation: New Insights on Possible Etiogenic Factors

Cited by 9 publications

References 4 publications

Acute kidney injury following HCT: incidence, risk factors and outcome

Acute kidney injury following HCT: incidence, risk factors and outcome

Chronic Kidney Disease in Long-Term Survivors of Hematopoietic Cell Transplantation

Renal involvement in children with malignancies

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