A Diverse Spectrum of Immune Complex– and Complement-Mediated Kidney Diseases Is Associated With Mantle Cell Lymphoma

Nicole K. Andeen; Shahad Abdulameer; Vivek Charu; Jonathan E. Zuckerman; Megan Troxell; Neeraja Kambham; Charles E. Alpers; Behzad Najafian; Roberto F. Nicosia; Kelly D. Smith; Vanderlene L. Kung; Rupali S. Avasare; Anusha Vallurupalli; J. Ashley Jefferson; Douglas Hecox; Leah Swetnam; Michifumi Yamashita; Mercury Lin; Mei Lin Bissonnette; Shreeram Akilesh; Jean Hou

Kidney International Reports (Mar 2022)

A Diverse Spectrum of Immune Complex– and Complement-Mediated Kidney Diseases Is Associated With Mantle Cell Lymphoma

Nicole K. Andeen,
Shahad Abdulameer,
Vivek Charu,
Jonathan E. Zuckerman,
Megan Troxell,
Neeraja Kambham,
Charles E. Alpers,
Behzad Najafian,
Roberto F. Nicosia,
Kelly D. Smith,
Vanderlene L. Kung,
Rupali S. Avasare,
Anusha Vallurupalli,
J. Ashley Jefferson,
Douglas Hecox,
Leah Swetnam,
Michifumi Yamashita,
Mercury Lin,
Mei Lin Bissonnette,
Shreeram Akilesh,
Jean Hou

Affiliations

Nicole K. Andeen: Department of Pathology, Oregon Health & Science University, Portland, Oregon, USA; Correspondence: Nicole K. Andeen, Department of Pathology, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road, Mail code: L113, Portland, Oregon 97239, USA.
Shahad Abdulameer: Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
Vivek Charu: Department of Pathology, Stanford University, Stanford, California, USA
Jonathan E. Zuckerman: Department of Pathology and Laboratory Medicine, University of California Los Angeles, Los Angeles, California, USA
Megan Troxell: Department of Pathology, Stanford University, Stanford, California, USA
Neeraja Kambham: Department of Pathology, Stanford University, Stanford, California, USA
Charles E. Alpers: Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
Behzad Najafian: Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
Roberto F. Nicosia: Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
Kelly D. Smith: Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
Vanderlene L. Kung: Department of Pathology, Oregon Health & Science University, Portland, Oregon, USA
Rupali S. Avasare: Division of Nephrology, Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA
Anusha Vallurupalli: Center for Hematologic Malignancies, Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA
J. Ashley Jefferson: Division of Nephrology, Department of Medicine, University of Washington, Seattle, Washington, USA
Douglas Hecox: Renal Care Consultants, Medford, Oregon, USA
Leah Swetnam: Nephrology, Kaiser Permanente, Portland, Oregon, USA
Michifumi Yamashita: Department of Pathology, Cedars Sinai Medical Center, Los Angeles, California, USA
Mercury Lin: Department of Pathology, Cedars Sinai Medical Center, Los Angeles, California, USA
Mei Lin Bissonnette: Department of Pathology, St Paul’s Hospital, The University of British Columbia, Vancouver, British Columbia, Canada
Shreeram Akilesh: Department of Laboratory Medicine and Pathology, University of Washington, Seattle, Washington, USA
Jean Hou: Department of Pathology, Cedars Sinai Medical Center, Los Angeles, California, USA

Journal volume & issue: Vol. 7, no. 3
pp. 568 – 579

Abstract

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Introduction: There are limited reports on kidney biopsy findings in patients with mantle cell lymphoma (MCL). Methods: We initiated a multi-institutional, retrospective review of kidney biopsy findings in patients with active and treated MCL. Results: A total of 30 patients with MCL and kidney biopsies were identified, with a median age of 67 (range 48–87) years, 73% of whom were men. A total of 20 patients had active MCL at the time of biopsy, of whom 14 (70%) presented with acute kidney injury (AKI), proteinuria and/or hematuria, and biopsy findings potentially attributable to lymphoma. Of the 14, 11 had immune complex (IC) or complement-mediated (C3) disease including proliferative glomerulonephritis (GN) with monotypic Ig deposits (PGNMID [2]), C3GN, (2), secondary membranous nephropathy (MN [3]), tubular basement membrane (TBM) deposits (2), and modest lupus-like GN (2). Lymphomatous infiltration was present in 8 of the 20 patients, 5 with coincident IC or C3 lesions. A total of 6 patients with available follow-up were treated for MCL, all with clinical remission of GN (2 PGNMID, 2 C3GN, and 2 MN). Conclusion: MCL is associated with diverse monoclonal and polyclonal glomerular and extra-glomerular IC and C3 disease. For patients with active MCL and kidney dysfunction requiring biopsy, 70% had findings due or potentially due to lymphoma, including 55% with IC or C3 disease and 40% had lymphomatous kidney infiltration. IC and C3GN in the setting of active MCL was responsive to lymphoma-directed therapy.

Published in Kidney International Reports

ISSN: 2468-0249 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the genitourinary system. Urology
Website: http://www.journals.elsevier.com/kidney-international-reports/

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