Acute lymphoblastic leukemia in a child with nephrotic syndrome

Monica Bhatia, Kanwal Kher, Caterina P. Minniti

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

A 5-year-old African-American male was diagnosed with nephrotic syndrome (NS). Because of concomitant leukopenia, bone marrow aspiration was performed, which did not demonstrate a hematological malignancy. The patient received standard daily steroid therapy for treatment of NS. Steroid resistance at 5 weeks of therapy led to a renal biopsy, which documented focal segmental glomerulosclerosis (FSGS). He was begun on cyclosporin A (CsA) and later switched to tacrolimus because of side-effects of CsA. Seven months after the initial diagnosis of NS, the patient was diagnosed with acute lymphoblastic leukemia (ALL). The patient is in complete remission of ALL and partial remission of NS with continued nephrotic-range proteinuria. Review of the literature shows four other cases of pediatric ALL after NS. No particular immunosuppressive agent seemed to be causative in the evolution of ALL. Although the exact mechanism for development of ALL after NS is unknown, the incidence of leukemia may be increased after immunosuppressive therapy when used in this context.

Original languageEnglish (US)
Pages (from-to)1290-1293
Number of pages4
JournalPediatric Nephrology
Volume19
Issue number11
DOIs
StatePublished - Nov 2004
Externally publishedYes

Fingerprint

Nephrotic Syndrome
Precursor Cell Lymphoblastic Leukemia-Lymphoma
Immunosuppressive Agents
Cyclosporine
Steroids
Focal Segmental Glomerulosclerosis
Leukopenia
Tacrolimus
Hematologic Neoplasms
Therapeutics
Proteinuria
African Americans
Leukemia
Bone Marrow
Pediatrics
Kidney
Biopsy
Incidence

Keywords

  • Acute lymphoblastic leukemia
  • Cyclosporin A
  • Focal segmental glomerulosclerosis
  • Immunosuppression
  • Nephrotic syndrome
  • Tacrolimus

ASJC Scopus subject areas

  • Nephrology
  • Pediatrics, Perinatology, and Child Health

Cite this

Acute lymphoblastic leukemia in a child with nephrotic syndrome. / Bhatia, Monica; Kher, Kanwal; Minniti, Caterina P.

In: Pediatric Nephrology, Vol. 19, No. 11, 11.2004, p. 1290-1293.

Research output: Contribution to journalArticle

Bhatia, Monica ; Kher, Kanwal ; Minniti, Caterina P. / Acute lymphoblastic leukemia in a child with nephrotic syndrome. In: Pediatric Nephrology. 2004 ; Vol. 19, No. 11. pp. 1290-1293.
@article{f54377ddd75d4cdeac6c57c38d5f89d1,
title = "Acute lymphoblastic leukemia in a child with nephrotic syndrome",
abstract = "A 5-year-old African-American male was diagnosed with nephrotic syndrome (NS). Because of concomitant leukopenia, bone marrow aspiration was performed, which did not demonstrate a hematological malignancy. The patient received standard daily steroid therapy for treatment of NS. Steroid resistance at 5 weeks of therapy led to a renal biopsy, which documented focal segmental glomerulosclerosis (FSGS). He was begun on cyclosporin A (CsA) and later switched to tacrolimus because of side-effects of CsA. Seven months after the initial diagnosis of NS, the patient was diagnosed with acute lymphoblastic leukemia (ALL). The patient is in complete remission of ALL and partial remission of NS with continued nephrotic-range proteinuria. Review of the literature shows four other cases of pediatric ALL after NS. No particular immunosuppressive agent seemed to be causative in the evolution of ALL. Although the exact mechanism for development of ALL after NS is unknown, the incidence of leukemia may be increased after immunosuppressive therapy when used in this context.",
keywords = "Acute lymphoblastic leukemia, Cyclosporin A, Focal segmental glomerulosclerosis, Immunosuppression, Nephrotic syndrome, Tacrolimus",
author = "Monica Bhatia and Kanwal Kher and Minniti, {Caterina P.}",
year = "2004",
month = "11",
doi = "10.1007/s00467-004-1591-0",
language = "English (US)",
volume = "19",
pages = "1290--1293",
journal = "Pediatric Nephrology",
issn = "0931-041X",
publisher = "Springer Verlag",
number = "11",

}

TY - JOUR

T1 - Acute lymphoblastic leukemia in a child with nephrotic syndrome

AU - Bhatia, Monica

AU - Kher, Kanwal

AU - Minniti, Caterina P.

PY - 2004/11

Y1 - 2004/11

N2 - A 5-year-old African-American male was diagnosed with nephrotic syndrome (NS). Because of concomitant leukopenia, bone marrow aspiration was performed, which did not demonstrate a hematological malignancy. The patient received standard daily steroid therapy for treatment of NS. Steroid resistance at 5 weeks of therapy led to a renal biopsy, which documented focal segmental glomerulosclerosis (FSGS). He was begun on cyclosporin A (CsA) and later switched to tacrolimus because of side-effects of CsA. Seven months after the initial diagnosis of NS, the patient was diagnosed with acute lymphoblastic leukemia (ALL). The patient is in complete remission of ALL and partial remission of NS with continued nephrotic-range proteinuria. Review of the literature shows four other cases of pediatric ALL after NS. No particular immunosuppressive agent seemed to be causative in the evolution of ALL. Although the exact mechanism for development of ALL after NS is unknown, the incidence of leukemia may be increased after immunosuppressive therapy when used in this context.

AB - A 5-year-old African-American male was diagnosed with nephrotic syndrome (NS). Because of concomitant leukopenia, bone marrow aspiration was performed, which did not demonstrate a hematological malignancy. The patient received standard daily steroid therapy for treatment of NS. Steroid resistance at 5 weeks of therapy led to a renal biopsy, which documented focal segmental glomerulosclerosis (FSGS). He was begun on cyclosporin A (CsA) and later switched to tacrolimus because of side-effects of CsA. Seven months after the initial diagnosis of NS, the patient was diagnosed with acute lymphoblastic leukemia (ALL). The patient is in complete remission of ALL and partial remission of NS with continued nephrotic-range proteinuria. Review of the literature shows four other cases of pediatric ALL after NS. No particular immunosuppressive agent seemed to be causative in the evolution of ALL. Although the exact mechanism for development of ALL after NS is unknown, the incidence of leukemia may be increased after immunosuppressive therapy when used in this context.

KW - Acute lymphoblastic leukemia

KW - Cyclosporin A

KW - Focal segmental glomerulosclerosis

KW - Immunosuppression

KW - Nephrotic syndrome

KW - Tacrolimus

UR - http://www.scopus.com/inward/record.url?scp=7744239240&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=7744239240&partnerID=8YFLogxK

U2 - 10.1007/s00467-004-1591-0

DO - 10.1007/s00467-004-1591-0

M3 - Article

C2 - 15372224

AN - SCOPUS:7744239240

VL - 19

SP - 1290

EP - 1293

JO - Pediatric Nephrology

JF - Pediatric Nephrology

SN - 0931-041X

IS - 11

ER -