Hematopoietic cell transplantation-related nephropathy in Japan.
To clarify the incidence and characteristics of hematopoietic cell transplantation (HCT)-related nephropathy (HCT-N) in Japan, we sent questionnaire letters to 188 hematologic divisions of 91 hospitals and analyzed the responses. Of 2,136 Japanese hematopoietic cell transplant recipients, 51 patients (2.4%) had HCT-N. The early-onset (</=30 days after HCT), middle-onset (31 to 120 days after HCT), and late-onset (>180 days after HCT) groups included 20, 16, and 15 patients, respectively. The early-onset group mainly consisted of patients with acute renal failure (ARF) and hemolytic uremic syndrome and/or thrombotic thrombocytopenic purpura. ARF was the dominant type in the middle-onset group. The main phenotype of the late-onset group was nephrotic syndrome, which correlated with chronic graft-versus-host disease (P=0.008). The total amounts of irradiation for patients with chronic renal failure and urinary abnormality were significantly greater than those for patients with ARF (P=0.004). The survival rate of the early-onset and middle-onset groups was 47.2%, whereas 87% of patients in the late-onset group survived (P=0.002). HCT-N is expected to become a serious and important problem in Japan because of the increasing number of HCTs from unrelated donors.
Imai
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H
Third Department of Internal Medicine, Akita University School of Medicine, Akita City, Japan. imaihiro@med.akita-u.ac.jp
Oyama
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Y
Miura
A B
AB
Endoh
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M
Sakai
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H
D000293:Adolescent; D000328:Adult; D002648:Child; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000401:mortality / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D007674:Kidney Diseases / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D051437:Renal Insufficiency / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires; D015996:Survival Rate