Kidney Involvement in Patients With Chronic Myelomonocytic Leukemia or BCR-ABL–Negative Myeloproliferative Neoplasms
Julie Bellière, Magali Colombat, Clément Kounde, Christian Récher, David Ribes, Antoine Huart, Dominique Chauveau, Véronique Demas, Isabelle Luquet, Odile Beyne-Rauzy, Suzanne Tavitian, Stanislas Faguer
Abstract
INTRODUCTION: The identification of specific molecular signatures and the development of new targeted drugs have changed the paradigm of onco-nephrology, now allowing a multiscale approach of kidney involvement related to hematologic malignancies relying on combined hematologic and molecular assessments. In this study, we aimed to refine the spectrum of kidney disorders associated with chronic myelomonocytic leukemia (CMML) or BCR-ABL-negative myeloproliferative neoplasms (MPNs), 2 very rare conditions scarcely described. METHODS: Case series. Patients with myeloid neoplasms who were referred to Toulouse University Hospital Nephrology Unit and were diagnosed with acute kidney injury (AKI), chronic kidney disease (CKD), or urine abnormalities were retrospectively included. RESULTS: =1). Massive kidney infiltration by CMML was identified in 1 patient. After a mean follow-up of 24±6 months, malignancy was considered as stable in 11 patients (61%), but 22% of patients had progressed to end-stage renal failure. The remaining had persistently reduced kidney function. No correlation between the malignancy and the renal presentation and outcomes could be identified. CONCLUSIONS: Kidney complications of CMML/MPN are heterogenous, and kidney biopsy may help to identify new molecular targets to prevent the development of kidney fibrosis.