title: Screening of renal dysfunction among Burkitt lymphoma survivors by novel markers.
abstract: BACKGROUND
  Burkitt lymphoma (BL) represents the most common pathological type of non-Hodgkin lymphoma in our region. Recently, high success rates have been achieved in BL treatment. Little is known about long-term renal dysfunction in this vulnerable group. In the present study, we tried to detect early chronic kidney diseases (CKD) among BL survivors by using novel screening modalities.
  
  
  METHODS
  we investigated 53 children (aged 10 ± 2.8 years, 34 boys) who successfully treated for Burkitt lymphoma, based on LMB96 protocol, as "patient group" and 30 children as control. All eligible participants were subjected to history taking, physical assessment, and routine laboratory investigations including urine analysis, serum creatinine. Estimated glomerular filtration rates using new Schwartz formula (GFRCKD) were calculated and chronic kidney disease prevalence was diagnosed accordingly. Also, serum Cystatin-C (Cys-C) and neutrophil-gelatinase-associated Lipocalin (NGAL) were determined as novel markers aiming at early and accurate detection of CKD in BL survivors.
  
  
  RESULTS
  After 18.3 ± 5.2 months of BL cytotoxic therapy completion, almost one fifth of asymptomatic BL survivors showed evidence of subclinical CKD when estimated GFRCKD(16.9%), serum Cystatin-C (15%) and serum neutrophil-gelatinase-associated Lipocalin (18.8%) were used for kidney function monitoring. This prevalence was four to fivefolds higher than that detected by routine serum creatinine screening (3.7%). Significant persistent albuminuria was diagnosed at 4/53 (7.5.3%) of BL survivors and asymptomatic hypertension was reported in 1/53 (1.9%) of them compared to none of the controls. Positive correlation could be displayed between serum Cys-C and serum NGAL. Conversely, negative correlations between both of them and estimated GFRCKDwere documented.
  
  
  CONCLUSIONS
  Novel modalities such new Schwartz formula (GFRCKD) estimation, serum Cys-C, and serum NGAL assessment should be incorporated in the routine follow-up screening for CKD among BL survivors for accurate diagnosis of such detrimental morbidity.
authors.affiliation: a Faculty of Medicine , Zagazig University , Egypt.
authors.forename: Laila Metwaly
authors.initials: LM
authors.lastname: Sherief
authors.affiliation: b Zagazig University , Zahraanasr City , Egypt.
authors.forename: Doaa Mohammed
authors.initials: DM
authors.lastname: Youssef
authors.affiliation: a Faculty of Medicine , Zagazig University , Egypt.
authors.forename: Hanan Saker
authors.initials: HS
authors.lastname: Sherbiny
authors.affiliation: a Faculty of Medicine , Zagazig University , Egypt.
authors.forename: Elhamy
authors.initials: E
authors.lastname: Abdelkhalek
authors.affiliation: a Faculty of Medicine , Zagazig University , Egypt.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Talaat
authors.affiliation: a Faculty of Medicine , Zagazig University , Egypt.
authors.forename: Naglaa Ali
authors.initials: NA
authors.lastname: Khalifa
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage* / Q000009:adverse effects; D015415:Biomarkers / Q000097:blood; D002051:Burkitt Lymphoma / Q000097:blood* / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D055316:Cystatin C / Q000097:blood*; D005260:Female; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006801:Humans; D007674:Kidney Diseases / Q000097:blood* / Q000139:chemically induced / Q000503:physiopathology; D000071068:Lipocalin-2 / Q000097:blood*; D008297:Male; D017741:Survivors
chemical_list: D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; C489506:LCN2 protein, human; D000071068:Lipocalin-2
keywords: Burkitt; Pediatrics; long term; renal