title: The Management of Membranous Glomerulopathy in Allogeneic Stem Cells Transplantation: Updated Literature
abstract: membranous glomerulopathy (MG) is an immunomediated disorder which accounts for the most common cause of nephrotic syndrome (NS) following allogeneic hematopoietic stem cell transplantation (HSCT).
  
  
  
  to provide an update on the issue by reviewing pertinent literature on the MEDLINE database.
  
  
  
  sixty-nine post allogenic HSCT patients (42 male) with MG were identified. The median age was 43 (5 to 68) years. Time interval from allogenic HSCT to MG diagnosis ranged from 3 to 134 months (median 17). Most MG patients had a history of acute (70%) or chronic (84%) graft versus host disease (GVHD). Corticosteroids and cyclosporine were the most common therapeutic agents used in this setting; alternative therapies, including rituximab, were given to a lower number of patients. Outcome data were available in 64 out of 69 MG patients; 38 (59%) and 18 (28%) patients achieved a complete and a partial response respectively, whereas treatment failure was recorded in the remaining 8 (13%).
  
  
  
  MG after allogenic HSCT appears to be associated with a sub clinical or overt cGVHD, which follows the discontinuation of immunosuppressive prophylaxis. Although a standard therapeutic approach has not been established, the application of available measures can induce favorable response in more than 80% of affected patients, but treatment-failure and progressive deterioration of the renal function may occur in about one fifth of cases.
authors.affiliation: Hematology Unit, Saint Eugenio Hospital, Tor Vergata University of Rome, Italy. pniscola@gmail.com
authors.forename: Pasquale
authors.initials: P
authors.lastname: Niscola
authors.forename: Andrea
authors.initials: A
authors.lastname: Tendas
authors.forename: Xiao-dan
authors.initials: XD
authors.lastname: Luo
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Catalano
authors.forename: Laura
authors.initials: L
authors.lastname: Scaramucci
authors.forename: Luca
authors.initials: L
authors.lastname: Cupelli
authors.forename: Marco
authors.initials: M
authors.lastname: Giovannini
authors.forename: Michele
authors.initials: M
authors.lastname: Ferrannini
authors.forename: Francesco
authors.initials: F
authors.lastname: Bondanini
authors.forename: Daniela
authors.initials: D
authors.lastname: Piccioni
authors.forename: Teresa
authors.initials: T
authors.lastname: Dentamaro
authors.forename: Roberto
authors.initials: R
authors.lastname: Palumbo
authors.forename: Alessio Pio
authors.initials: AP
authors.lastname: Perrotti
authors.forename: Qi-fa
authors.initials: QF
authors.lastname: Liu
authors.forename: Paolo
authors.initials: P
authors.lastname: de Fabritiis
mesh_terms: D015433:Glomerulonephritis, Membranous / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D012307:Risk Factors; D014184:Transplantation, Homologous / Q000009:adverse effects*