Paola Casciani1, Massimiliano Postorino1, Francesca Rossi2, Sergio Tripodi3, Annalisa Biagi1, Lisa Mercante1, Roberta Laureana1, Enrico Santinelli1, Maria Ilaria Del Principe1, Valter Gattei2 and Giovanni Del Poeta1*
1Department of Biomedicine and Prevention, Università Tor Vergata, Italy 2IRCCS Centro di Riferimento Oncologico, Italy 3UOC Pathological Anatomy, Azienda Ospedaliera Universitaria, ItalyFulltext PDF
The incidence of a renal lymphocytic infiltration in Chronic Lymphocytic Leukemia (CLL) is a fairly common phenomenon, found in a variable percentage of cases, as a result of autopsy studies. However, it is uncommon the association of the infiltrate with specific renal histopathological alterations, such as a Granulomatous Interstitial Nephritis (GIN), with severe kidney function impairment. We describe a patient with progressive TP53 mutated CLL who developed acute renal failure due to leukemic infiltration associated with GIN during treatment with ibrutinib, the new inhibitor of the Bruton’s tyrosine kinase. After stopping ibrutinib, the patient obtained a complete remission with high doses of prednisone plus chemoimmunotherapy, but recently he underwent relapse treated now with venetoclax plus prednisone.
Casciani P, Postorino M, Rossi F, Tripodi S, Biagi A, Mercante L, et al. Renal Failure in a Patient with Ibrutinib Refractory Chronic Lymphocytic Leukemia. Ann Clin Case Rep. 2019; 4: 1749.