Acute kidney injury presenting a feature of leukemic infiltration during therapy for chronic myelogenous leukemia.
Chronic myelogenous leukemia (CML) is a myeloproliferative disease that originates in abnormal pluripotent bone marrow stem cells and it is consistently associated with the Philadelphia chromosome and/or BCR/ ABL fusion gene. Renal infiltration of leukemic cells is relatively rare in CML and is associated with renal impairment. We describe a patient who developed acute renal failure by tubulointerstitial nephropathy during treatment with imatinib mesylate for CML. The acute kidney injury was subsequently found to be due to direct leukemic infiltration. Treatment with hydroxycarbamide and prednisolone resulted in stabilization of the renal function for approximately 4 months. Leukemic infiltration into the kidney should always be considered when a patient with CML presents with renal impairment, regardless of the clinical stage, as the renal failure often responds well to chemotherapy.
Yuzawa
Yukio
Y
Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Japan. yukio@med.nagoya-u.ac.jp
Sato
Waichi
W
Masuda
Tomohiro
T
Hamada
Yuzuru
Y
Tatematsu
Miho
M
Yasuda
Yoshinari
Y
Ozaki
Takenori
T
Ito
Isao
I
Mizuno
Masashi
M
Maruyama
Shoichi
S
Ito
Yasuhiko
Y
Matsuo
Seiichi
S
D058186:Acute Kidney Injury / Q000175:diagnosis / Q000209:etiology / Q000473:pathology*; D000369:Aged, 80 and over; D001549:Benzamides; D003937:Diagnosis, Differential; D006801:Humans; D000068877:Imatinib Mesylate; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000188:drug therapy* / Q000473:pathology*; D017254:Leukemic Infiltration / Q000150:complications / Q000175:diagnosis*; D008297:Male; D010879:Piperazines / Q000009:adverse effects / Q000627:therapeutic use*; D011743:Pyrimidines / Q000009:adverse effects / Q000627:therapeutic use*
D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate