title: Renal function after tandem high-dose chemotherapy and autologous stem cell transplantation in children with Wilms tumor.
abstract: Despite increasing evidence that tandem HDCT and autoSCT might improve the survival of patients with high-risk solid tumors, patients with Wilms tumor may be at high risk of acute and chronic renal impairment during and after tandem HDCT/autoSCT because they usually have a single kidney. We investigated the feasibility of tandem HDCT/autoSCT in patients with Wilms tumor, focusing on renal function. Six patients with relapsed/progressed Wilms tumor were assigned to undergo tandem HDCT/autoSCT. One patient developed transient ARF during the first HDCT/autoSCT. All other patients underwent the second HDCT/autoSCT as scheduled. Acute renal dysfunction during the second HDCT/autoSCT was transient and manageable. Indicators of glomerular function such as creatinine clearance, serum creatinine, and albumin excretion were in the normal range at three yr after tandem HDCT/autoSCT. Subclinical tubular dysfunctions, such as increased excretion of β-N-acetylglucosaminidase and β2-microglobulin, were identified at one and three yr after tandem HDCT/autoSCT; however, no patient required treatment for these conditions. These results are helpful to consider tandem HDCT/autoSCT as a treatment option in patients with Wilms tumor. Longer duration of follow-up and close monitoring of tubular function are required if tandem HDCT/autoSCT is indicated in patients with Wilms tumor.
authors: Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors: Soo Hyun
authors: SH
authors: Lee
authors: Kyung Hoon
authors: KH
authors: Paik
authors: Ki Woong
authors: KW
authors: Sung
authors: Meong Hi
authors: MH
authors: Son
authors: Keon Hee
authors: KH
authors: Yoo
authors: Hong Hoe
authors: HH
authors: Koo
authors: Ju Youn
authors: JY
authors: Kim
authors: Eun Joo
authors: EJ
authors: Cho
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology*; D007680:Kidney Neoplasms / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D033581:Stem Cell Transplantation / Q000009:adverse effects; D014182:Transplantation, Autologous; D009396:Wilms Tumor / Q000503:physiopathology / Q000628:therapy*