Journal of Blood Disorders & Transfusion

Effective therapy of lymphoproliferative diseases associated with glomerulonephritis and renal failure

16^th World Hematology Congress

March 18-19, 2019 | Rome, Italy

B T Dzhumabaeva, L S Biryukova, S A Maryina and E Gemdzhian

National Research Center for Hematology, Russia

Posters & Accepted Abstracts: Blood Disord Transfus

Abstract:

Summary: Therapy for lymphoproliferative disorders (LPD) associated with glomerulonephritis remains a problem.

Objective: To evaluate the efficacy of bendamustine and rituximab treatment for LPD associated with glomerulonephritis.

Materials & Methods: The study included five patients with LPD complicated by renal failure, chronic lymphocytic leukemia/small cell lymphocytic lymphoma (CLL/SLL, n=3) and marginal zone lymphoma (MZL, n=2). Median age of patients was 64 years (39-69 yrs), male/female ratio 2/3. Mesangioproliferative glomerulonephritis in one case, mesangiocapillary glomerulonephritis in two, fibrillar glomerulonephritis in one, glomerulopathy with minimal changes in one was established through study of kidney biopsies. Glomerulonephritis was accompanied with the interstitial tumor lymphocytic infiltrates in two cases and with thrombotic microangiopathy in two cases. Cryoglobulinemia was detected in three patients. Monoclonal paraprotein IgM? was detected in two and Bence- Jones protein kappa in one. The patients received combination of rituximab with bendamustine (BR): rituximab at a dose of 375 mg/m2 on day one of 28 day cycle and bendamustine at a dose of 70 mg/m2 on day second and third of 28 day cycle for up to six cycles.

Results: Positive effect of therapy with BR was achieved in all five patients. Complete remission of LPD was achieved in four patients, partial remission in one patient. Relapse of the disease was observed in one patient in 37 months after therapy. Other four patients without relapse are observed for 39 and 46 months. Renal function improved in three patients, the glomerular filtration rate (GFR) increased from 36 to 63 mL/min. Renal function did not improve in two patients in whom GFR in pretreatment time was less than 20 mL/min. Cryoglobulinemia disappeared after therapy in three patients. Hematologic toxicity (anemia and neutropenia and thrombocytopenia) were observed mainly mild during therapy were observed in two patients without infection complications.

Conclusion: The BR regimen in the treatment of CLL and LMZ associated with glomerulonephritis and renal failure in the debut of the disease is effective and can be used as an alternative regimen in first line therapy.

Biography :

E-mail: bola.blood@yandex.ru