Vos, Josephine M.;
Gustine, Joshua;
Rennke, Helmut G.;
Hunter, Zachary;
Manning, Robert J.;
Dubeau, Toni E.;
Meid, Kirsten;
Minnema, Monique C.;
Kersten, Marie‐Jose;
Treon, Steven P.;
Castillo, Jorge J.
Renal disease related to Waldenström macroglobulinaemia: incidence, pathology and clinical outcomes
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Media type:
E-Article
Title:
Renal disease related to Waldenström macroglobulinaemia: incidence, pathology and clinical outcomes
Contributor:
Vos, Josephine M.;
Gustine, Joshua;
Rennke, Helmut G.;
Hunter, Zachary;
Manning, Robert J.;
Dubeau, Toni E.;
Meid, Kirsten;
Minnema, Monique C.;
Kersten, Marie‐Jose;
Treon, Steven P.;
Castillo, Jorge J.
Description:
<jats:title>Summary</jats:title><jats:p>The incidence and prognostic impact of nephropathy related to Waldenström macroglobulinaemia (<jats:styled-content style="fixed-case">WM</jats:styled-content>) is currently unknown. We performed a retrospective study to assess biopsy‐confirmed <jats:styled-content style="fixed-case">WM</jats:styled-content>‐related nephropathy in a cohort of 1391 <jats:styled-content style="fixed-case">WM</jats:styled-content> patients seen at a single academic institution. A total of 44 cases were identified, the estimated cumulative incidence was 5·1% at 15 years. There was a wide variation in kidney pathology, some directly related to the <jats:styled-content style="fixed-case">WM</jats:styled-content>: amyloidosis (<jats:italic>n</jats:italic> = 11, 25%), monoclonal‐IgM deposition disease/cryoglobulinaemia (<jats:italic>n</jats:italic> = 10, 23%), lymphoplasmacytic lymphoma infiltration (<jats:italic>n</jats:italic> = 8, 18%), light‐chain deposition disease (<jats:italic>n</jats:italic> = 4, 9%) and light‐chain cast nephropathy (<jats:italic>n</jats:italic> = 4, 9%), and some probably related to the <jats:styled-content style="fixed-case">WM</jats:styled-content>: thrombotic microangiopathy (<jats:styled-content style="fixed-case">TMA</jats:styled-content>) (<jats:italic>n</jats:italic> = 3, 7%), minimal change disease (<jats:italic>n</jats:italic> = 2, 5%), membranous nephropathy (<jats:italic>n</jats:italic> = 1, 2%) and crystal‐storing tubulopathy (<jats:italic>n</jats:italic> = 1, 2%). The median overall survival in patients with biopsy‐confirmed <jats:styled-content style="fixed-case">WM</jats:styled-content>‐related nephropathy was 11·5 years, shorter than for the rest of the cohort (16 years, <jats:italic>P</jats:italic> = 0·03). Survival was better in patients with stable or improved renal function after treatment (<jats:italic>P</jats:italic> = 0·05). Based on these findings, monitoring for renal disease in <jats:styled-content style="fixed-case">WM</jats:styled-content> patients should be considered and a kidney biopsy pursued in those presenting with otherwise unexplained renal failure and/or nephrotic syndrome.</jats:p>