Acute Kidney Injury after Bone Marrow Transplantation in Patients with Lymphomas and Leukemias
DOI:
https://doi.org/10.32635/2176-9745.RBC.2023v69n1.3423Keywords:
leukemia, lymphoma, bone marrow transplantation, acute kidney injuryAbstract
Introduction: Hematologic malignancies, including lymphomas and leukemias, may be treated with autologous or allogeneic bone marrow transplantation. However, these approaches can increase the risk of infection, sepsis, graft-versus-host disease, and nephrotoxicity, possibly resulting in acute kidney injury (AKI). Objective: To evaluate AKI in patients with lymphomas or leukemia submitted to bone marrow transplantation (BMT). Method: Retrospective, observational cohort study of cases from a database of 256 patients (53.9% males) hospitalized for BMT between 2012 and 2014 at a cancer hospital in Sao Paulo, Brazil. Of these, 79 were selected randomly for analysis. Demographic data, length of hospitalization, and associated morbidities were recorded. AKI was identified according to Kidney Diseases Improving Global Outcomes (KDIGO) criteria. Results: The most frequent diagnoses for the 79 cases were non-Hodgkin’s lymphoma (30.4%), acute myeloid leukemia (26.6%), and Hodgkin’s lymphoma (24.1%). The probability of 100 days-survival after BMT was 81%, and three years after BMT was 61%. In-hospital mortality was significantly higher among patients who presented AKI during hospitalization (p<0.001). However, there was no difference in overall life expectancy (p=0.770). Conclusion: A significant prevalence of AKI was found in patients with leukemia or lymphoma while they were hospitalized for BMT, resulting in significantly increased rates of in-hospital mortality. The presence of AKI during hospitalization was not associated with a subsequent reduction in life expectancy.
Downloads
References
Welch JS, Petti AA, Miller CA, et al. TP53 and decitabine in acute myeloid leukemia and myelodysplastic syndromes. N Engl J Med. 2016;375(21):2023-36. doi: https://doi.org/10.1056/NEJMoa1605949 DOI: https://doi.org/10.1056/NEJMoa1605949
Appelbaum FR. Consolidation chemotherapy prior to hematopoietic cell transplantation for adults with acute myeloid leukemia in first remission. Best Pract Res Clin Haematol. 2016;29(4):365-71. doi: https://doi.org/10.1016/j.beha.2016.10.012 DOI: https://doi.org/10.1016/j.beha.2016.10.012
Silva DB, Pires MM, Nassar SM. Câncer pediátrico: análise de um registro hospitalar. J Pediatr (Rio J). 2002;78(5):409-14. doi: https://doi.org/10.1590/S0021-75572002000500012 DOI: https://doi.org/10.1590/S0021-75572002000500012
Instituto Nacional de Câncer. Estimativa 2023: incidência de câncer no Brasil [Internet]. Rio de Janeiro: INCA; 2022 [acesso 2023 fev 27]. Disponível em: https://www.inca.gov.br/sites/ufu.sti.inca.local/files//media/document//estimativa-2023.pdf
Loh JW, Khiabanian H. Leukemia’s clonal evolution in development, progression, and relapse. Curr Stem Cell Rep. 2019;5:73-81. doi: https://doi.org/10.1007/s40778-019-00157-y DOI: https://doi.org/10.1007/s40778-019-00157-y
Press RD, Eickelberg G, Froman A, et al. Next-generation sequencing-defined minimal residual disease before stem cell transplantation predicts acute myeloid leukemia relapse. Am J Hematol. 2019;94(8):902-12. doi: https://doi.org/10.1002/ajh.25514 DOI: https://doi.org/10.1002/ajh.25514
Xia D, Nardi V, Hasserjian RP. Molecular genetic testing in the diagnosis of myeloid neoplasms. Diagn Histopathol. 2019;25(6):249-59. doi: https://doi.org/10.1016/j.mpdhp.2019.04.004 DOI: https://doi.org/10.1016/j.mpdhp.2019.04.004
Harris NL, Jaffe ES, Diebold J, et al. The World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues. Report of the Clinical Advisory Committee meeting, Airlie House, Virginia, November, 1997. J Clin Oncol. 1999;17(12):3835-49. doi: https://doi.org/10.1200/JCO.1999.17.12.3835 DOI: https://doi.org/10.1200/JCO.1999.17.12.3835
Araújo LHL, Victorino AP, Melo AC, et al. Linfoma não-Hodgkin de alto grau - revisão de literatura. Rev Bras Cancerol. 2008;54(2):175-83. doi: https://doi.org/10.32635/2176-9745.RBC.2008v54n2.1747 DOI: https://doi.org/10.32635/2176-9745.RBC.2008v54n2.1747
Fisher RI, Mauch PM, Harris NL, et al. No Hodgkin’s lymphoma. In: DeVita VT Jr, Hellman S, Rosenberg SA. Cancer: principles and practice of oncology. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2005. p. 1957-7.
Cabanillas F, Velasquez WS, Hagemeister FB, et al. Clinical, biologic, and histologic features of late relapses in diffuse large cell lymphoma. Blood. 1992;79(4):1024-8. doi: https://doi.org/10.1182/blood.V79.4.1024.1024 DOI: https://doi.org/10.1182/blood.V79.4.1024.1024
SIM: Sistema de Informação sobre Mortalidade [Internet]. Versão 3.2.1.2. Brasília (DF): DATASUS. [data desconhecida] - [acesso 2023 mar 11]. Disponível em: http://sim.saude.gov.br/default.asp
Fedele R, Martino M, Recchia AG, et al. Clinical options in relapsed or refractory Hodgkin lymphoma: an updated review. J Immunol Res. 2015:2015:968212. doi: https://doi.org/10.1155/2015/968212 DOI: https://doi.org/10.1155/2015/968212
National Cancer Institute (US) [Internet]. Bethesda (MD): National Cancer Institute (US); [date unknown]. Adult Non-Hodgkin Lymphoma Treatment (PDQ®): health professional version; [updated 2023 Feb 17; cited 2013, March 11]. Available from: https://www.cancer.gov/types/lymphoma/hp/adult-nhl-treatment-pdq
El-Asmar J, Gonzalez R, Bookout R, et al. Clotrimazole troches induce supratherapeutic blood levels of sirolimus and tacrolimus in an allogeneic hematopoietic cell-transplant recipient resulting in acute kidney injury. Hematol Oncol Stem Cell Ther. 2016;9(4):157-61. doi: https://doi.org/10.1016/j.hemonc.2015.11.001 DOI: https://doi.org/10.1016/j.hemonc.2015.11.001
Hingorani S. Renal complications of hematopoietic-cell transplantation. N Engl J Med. 2016;374(23):2256-67. doi: https://doi.org/10.1056/NEJMra1404711 DOI: https://doi.org/10.1056/NEJMra1404711
Yu ZP, Ding JH, Chen BA, et al. Risk factors for acute kidney injury in patients undergoing allogeneic hematopoietic stem cell transplantation. Chin J Cancer. 2010;29(11):946-51. doi: https://doi.org/10.5732/cjc.010.10293 DOI: https://doi.org/10.5732/cjc.010.10293
Parikh CR, McSweeney PA, Korular D, et al. Renal dysfunction in allogeneic hematopoietic cell transplantation. Kidney Int. 2002;62(2):566-73. doi: https://doi.org/10.1046/j.1523-1755.2002.00455.x DOI: https://doi.org/10.1046/j.1523-1755.2002.00455.x
Hingorani SR, Guthrie K, Batchelder A, et al. Acute renal failure after myeloablative hematopoietic cell transplant: incidence and risk factors. Kidney Int. 2005;67(1):272-7. doi: https://doi.org/10.1111/j.1523-1755.2005.00078.x DOI: https://doi.org/10.1111/j.1523-1755.2005.00078.x
Parikh CR, Coca SG. Acute renal failure in hematopoietic cell transplantation. Kidney Int. 2006;69(3):430-5. doi: https://doi.org/10.1038/sj.ki.5000055 DOI: https://doi.org/10.1038/sj.ki.5000055
Santos JCO, Mendonça MAO. Fatores predisponentes para lesão renal aguda em pacientes em estado crítico: revisão integrativa. Rev Soc Bras Clin Med [Internet]. 2015 [acesso 2023 mar 11];13(1):69-74. Disponível em: http://files.bvs.br/upload/S/1679-1010/2015/v13n1/a4780.pdf
Troxell ML, Higgins JP, Kambham N. Renal pathology associated with hematopoietic stem cell transplantation. Adv Anat Pathol. 2014;21(5):330-40. doi: https://doi.org/10.1097/PAP.0000000000000034 DOI: https://doi.org/10.1097/PAP.0000000000000034
Rosner MT, Perazella MA. Acute kidney injury in patients with cancer. N Engl J Med. 2017;376(18):1770-81. doi: https://doi.org/10.1056/NEJMra1613984 DOI: https://doi.org/10.1056/NEJMra1613984
KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl [Internet]. 2012 [cited 2022 Dec 22];2:1-138. Available from: https://kdigo.org/wp-content/uploads/2016/10/KDIGO-2012-AKI-Guideline-English.pdf
Alaggio R, Amador C, Anagnostopoulos I, et al. The 5th edition of the World Health Organization classification of haematolymphoid tumours: lymphoid neoplasms. Leukemia. 2022;36(7):1720-48. doi: https://doi.org/10.1038/s41375-022-01620-2 DOI: https://doi.org/10.1038/s41375-022-01620-2
Cree IA. The WHO classification of haematolymphoid tumours. Leukemia. 2022;36:1701-2. doi: https://doi.org/10.1038/s41375-022-01625-x DOI: https://doi.org/10.1038/s41375-022-01625-x
Troxell ML, Higgins JP, Kambham N. Antineoplastic treatment and renal injury: an update on renal pathology due to cytotoxic and targeted therapies. Adv Anat Pathol. 2016;23(5):310-29. doi: https://doi.org/10.1097/PAP.0000000000000122 DOI: https://doi.org/10.1097/PAP.0000000000000122
Parikh CR, Yarlagadda SG, Storer B, et al. Impact of acute kidney injury on long-term mortality after nonmyeloablative hematopoietic cell transplantation. Biol Blood Marrow Transplant. 2008;14(3):309-15. doi: https://doi.org/10.1016/j.bbmt.2007.12.492 DOI: https://doi.org/10.1016/j.bbmt.2007.12.492
Rosen DC, Kannappan M, Kim Y, et al. The impact of obesity in patients undergoing robotic partial nephrectomy. J Endourol. 2019;33(6):431-7. doi: https://doi.org/10.1089/end.2019.0018 DOI: https://doi.org/10.1089/end.2019.0018
Liu AYL, Wang J, Nikam M, et al. Low, rather than high, body mass index is a risk factor for acute kidney injury in multiethnic asian patients: a retrospective observational study. Int J Nephrol. 2018;2018:3284612. doi: https://doi.org/10.1155/2018/3284612 DOI: https://doi.org/10.1155/2018/3284612
Published
How to Cite
Issue
Section
License
Os direitos morais e intelectuais dos artigos pertencem aos respectivos autores, que concedem à RBC o direito de publicação.
![Creative Commons License](http://i.creativecommons.org/l/by/4.0/88x31.png)
This work is licensed under a Creative Commons Attribution 4.0 International License.