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Three cases of renal relapse after allogeneic hematopoietic stem cell transplantation for childhood acute lymphoblastic leukemia.
Haematologica. 2006 May; 91(5 Suppl):ECR07.H

Abstract

Isolated renal relapse after allogeneic hematopoietic stem cell transplantation (alloHSCT) in children with acute lymphoblastic leukemia (ALL) is a rare condition. Generally, in ALL, the sites most frequently affected by extramedullary relapse are the central nervous system (CNS) and the testicles. Here we report on three young boys with relapsed B-precursor ALL, who underwent alloHSCT from HLA-identical siblings and suffered a histopathologically proven isolated unilateral renal relapse (two patients) or a combined renal and testicular relapse (one patient) 6, 10 and 12 months post alloHSCT. In all patients at the time of relapse bone marrow showed complete remission with complete donor hematopoiesis. They all received total body irradiation with partial shielding of the kidneys as part of their conditioning therapy, such that renal shielding could be an explanation for the observed accumulation of renal relapses. Moreover, during the past few years so called immune privilege has been postulated for frequent relapse sites such as the CNS, the testicles and the anterior chamber of the eye. Impaired accessability of these organs by cytotoxic T-cells (CTLs) with a reduced graft-versus-leukemia (GvL) effect after alloHSCT is based on a number of different molecular and cellular mechanisms. Similar mechanisms have been shown to be effective in the tubulointerstitial space of the kidney, rendering the kidney a potentially immune privileged site. Due to these observations we advocate sufficient treatment of the kidneys during conditioning therapy.

Authors+Show Affiliations

Department of Pediatric Oncology, Hematology and Immunology, University Children's Hospital, Moorenstrasse 5, 40225 Dusseldorf, Germany.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

16709515

Citation

Huck, K, et al. "Three Cases of Renal Relapse After Allogeneic Hematopoietic Stem Cell Transplantation for Childhood Acute Lymphoblastic Leukemia." Haematologica, vol. 91, no. 5 Suppl, 2006, pp. ECR07.
Huck K, Laws HJ, Meisel R, et al. Three cases of renal relapse after allogeneic hematopoietic stem cell transplantation for childhood acute lymphoblastic leukemia. Haematologica. 2006;91(5 Suppl):ECR07.
Huck, K., Laws, H. J., Meisel, R., Traeger, A., Bernbeck, B., Schonberger, S., Stackelberg, V. A., Pape, H., & Dilloo, D. (2006). Three cases of renal relapse after allogeneic hematopoietic stem cell transplantation for childhood acute lymphoblastic leukemia. Haematologica, 91(5 Suppl), ECR07.
Huck K, et al. Three Cases of Renal Relapse After Allogeneic Hematopoietic Stem Cell Transplantation for Childhood Acute Lymphoblastic Leukemia. Haematologica. 2006;91(5 Suppl):ECR07. PubMed PMID: 16709515.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Three cases of renal relapse after allogeneic hematopoietic stem cell transplantation for childhood acute lymphoblastic leukemia. AU - Huck,K, AU - Laws,H-J, AU - Meisel,R, AU - Traeger,A, AU - Bernbeck,B, AU - Schonberger,S, AU - Stackelberg,V A, AU - Pape,H, AU - Dilloo,D, PY - 2006/5/20/pubmed PY - 2006/7/18/medline PY - 2006/5/20/entrez SP - ECR07 EP - ECR07 JF - Haematologica JO - Haematologica VL - 91 IS - 5 Suppl N2 - Isolated renal relapse after allogeneic hematopoietic stem cell transplantation (alloHSCT) in children with acute lymphoblastic leukemia (ALL) is a rare condition. Generally, in ALL, the sites most frequently affected by extramedullary relapse are the central nervous system (CNS) and the testicles. Here we report on three young boys with relapsed B-precursor ALL, who underwent alloHSCT from HLA-identical siblings and suffered a histopathologically proven isolated unilateral renal relapse (two patients) or a combined renal and testicular relapse (one patient) 6, 10 and 12 months post alloHSCT. In all patients at the time of relapse bone marrow showed complete remission with complete donor hematopoiesis. They all received total body irradiation with partial shielding of the kidneys as part of their conditioning therapy, such that renal shielding could be an explanation for the observed accumulation of renal relapses. Moreover, during the past few years so called immune privilege has been postulated for frequent relapse sites such as the CNS, the testicles and the anterior chamber of the eye. Impaired accessability of these organs by cytotoxic T-cells (CTLs) with a reduced graft-versus-leukemia (GvL) effect after alloHSCT is based on a number of different molecular and cellular mechanisms. Similar mechanisms have been shown to be effective in the tubulointerstitial space of the kidney, rendering the kidney a potentially immune privileged site. Due to these observations we advocate sufficient treatment of the kidneys during conditioning therapy. SN - 1592-8721 UR - https://www.unboundmedicine.com/medline/citation/16709515/Three_cases_of_renal_relapse_after_allogeneic_hematopoietic_stem_cell_transplantation_for_childhood_acute_lymphoblastic_leukemia_ L2 - http://www.diseaseinfosearch.org/result/188 DB - PRIME DP - Unbound Medicine ER -