Clinical characteristics of membranous nephropathy after allogeneic hematopoietic stem cell transplantation: A real-world multicenter study

Ann Hematol. 2024 Oct;103(10):4261-4270. doi: 10.1007/s00277-024-05875-w. Epub 2024 Jul 11.

Abstract

Membranous nephropathy (MN) is a rare complication that can occur after allogeneic hematopoietic stem cell transplantation (allo-HSCT). MN patients may develop nephrotic syndrome or even kidney failure, which greatly affects their quality of life and prognosis. However, current knowledge regarding MN after allo-HSCT is limited. Thus, a multicenter nested case‒control study was conducted. Patients who had been diagnosed with MN after allo-HSCT were retrospectively identified at 8 HSCT centers. A total of 51 patients with MN after allo-HSCT were included. The median age of MN patients after allo-HSCT was 38 years, and the median duration from HSCT to MN was 18 months. The use of HLA-matched donors (P = 0.0102) and peripheral blood as the graft source (P = 0.0060) were identified as independent predisposing risk factors for the onset of MN after allo-HSCT. Compared to those in the control group, the incidence of extensive chronic graft-versus-host disease was greater in the MN patients (P = 0.0002). A total of 31 patients developed nephrotic syndrome. Patients receiving combination treatments of corticosteroids and immunosuppressants appeared to have better outcomes. In conclusion, MN is a rare but occasionally severe complication following HSCT and may require active treatment.

Keywords: Allogeneic hematopoietic stem cell transplantation; Chronic graft-versus-host disease; Membranous nephropathy; Quality of life.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Allografts
  • Case-Control Studies
  • Female
  • Glomerulonephritis, Membranous* / epidemiology
  • Glomerulonephritis, Membranous* / etiology
  • Glomerulonephritis, Membranous* / therapy
  • Graft vs Host Disease / etiology
  • Hematopoietic Stem Cell Transplantation* / adverse effects
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Middle Aged
  • Nephrotic Syndrome / etiology
  • Nephrotic Syndrome / therapy
  • Retrospective Studies
  • Risk Factors
  • Transplantation, Homologous / adverse effects
  • Young Adult

Substances

  • Immunosuppressive Agents