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Post-Transplant Complications

Renal function after autologous bone marrow transplantation in children: a long-term prospective study

Bone Marrow Transplantation volume 29, pages 129–136 (2002)Cite this article

Abstract

We measured glomerular filtration rate (GFR), effective renal plasma flow (ERPF) and the concentrating capacity of the kidneys in children after autologous BMT. Twenty-six patients had received TBI in their conditioning regimen and 14 patients had received chemotherapy only. Median follow-up was 10 years. Mean GFR before BMT was close to normal in both groups. Mean GFR decreased from 124 [CI 114,134] ml/min/1.73 m2 before BMT to 99 [CI 82,115] ml/min/1.73 m2 6 months after BMT in the + TBI group (P < 0.001). There was no significant change in the −TBI group. Mean ERPF before BMT was high: 1110 [95% CI 830,1390] ml/min/1.73 m2 in the + TBI group and 910 [CI 570,1250] ml/min/1.73 m2 in the − TBI group. Six months after BMT, there was a tendency to a decrease in ERPF in the +TBI group, to 760 [CI 580,940] ml/min/1.73 m2 (P = 0.064). After this initial decrease, GFR and ERPF remained essentially unchanged in both groups. The mean concentrating capacity of the kidneys was normal before and after BMT. In seven patients chronic renal impairment developed after BMT (GFR <70 ml/min/1.73 m2). All had received TBI. They had also received more nephrotoxic antibiotics than the other patients. We conclude that TBI was the principal cause of deterioration of renal function after BMT, possibly by limiting compensatory hyperperfusion and resulting in a fall in GFR. Antibiotic treatment may have contributed.

Bone Marrow Transplantation (2002) 29, 129–136. doi:10.1038/sj.bmt.1703312

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References

  1. Zager RA, O'Quigley J, Zager BK et al. Acute renal failure following bone marrow transplantation: a retrospective study of 272 patients Am J Kidney Dis 1989 13: 210 216

    Article  CAS  Google Scholar 

  2. Zager RA . Nephrology forum: acute renal failure in the setting of bone marrow transplantation Kidney Int 1994 46: 1443 1458

    Article  CAS  Google Scholar 

  3. Gruss E, Bernis C, Tomas JF et al. Acute renal failure in patients following bone marrow transplantation: prevalence, risk factors and outcome Am J Nephrol 1995 15: 473 479

    Article  CAS  Google Scholar 

  4. Lane PH, Mauer SM, Blazar BR et al. Outcome of dialysis for acute renal failure in pediatric bone marrow transplant patients Bone Marrow Transplant 1994 13: 613 617

    CAS  Google Scholar 

  5. Van Why SK, Friedman AL, Wei LJ, Hong R . Renal impairment after bone marrow transplantation in children Bone Marrow Transplant 1991 7: 383 388

    CAS  Google Scholar 

  6. Kist-van Holthe JE, van Zwet JML, Brand R et al. Bone marrow transplantation in children: consequences for renal function shortly and 1 year post-BMT Bone Marrow Transplant 1998 22: 559 564

    Article  CAS  Google Scholar 

  7. Cannell PK, Herrmann RP . Urate metabolism during bone marrow transplantation Bone Marrow Transplant 1992 10: 337 339

    CAS  PubMed  Google Scholar 

  8. Okamoto Y, Takaue S, Saito S et al. Toxicities associated with cryopreserved and thawed peripheral blood stem cell autografts in children with active cancer Transfusion 1993 33: 578 581

    Article  CAS  Google Scholar 

  9. Tarbell NJ, Guinan EC, Niemeyer C et al. Late onset renal dysfunction in survivors of bone marrow transplantation Int J Radiat Oncol Biol Phys 1988 15: 99 104

    Article  CAS  Google Scholar 

  10. Guinan EC, Tarbell NJ, Niemeyer CM et al. Intravascular hemolysis and renal impairment after bone marrow transplantation Blood 1988 72: 451 455

    CAS  Google Scholar 

  11. Antignac C, Gubler M-C, Leverger G et al. Delayed renal failure with extensive mesangiolysis following bone marrow transplantation Kidney Int 1989 35: 1336 1344

    Article  CAS  Google Scholar 

  12. Lönnerholm G, Carlson K, Bratteby L-E et al. Renal function after autologous bone marrow transplantation Bone Marrow Transplant 1991 8: 129 134

    PubMed  Google Scholar 

  13. Bergstein J, Andreoli SP, Provisor AJ, Yum M . Radiation nephritis following total body irradiation and cyclophosphamide in preparation for bone marrow transplantation Transplantation 1986 41: 63 66

    Article  CAS  Google Scholar 

  14. Lawton CA, Cohen EP, Barber-Derus SW et al. Late renal dysfunction in adult survivors of bone marrow transplantation Cancer 1991 67: 2795 2800

    Article  CAS  Google Scholar 

  15. Cohen EP, Lawton CA, Moulder JE et al. Clinical course of late-onset bone marrow transplant nephropathy Nephron 1993 64: 626 635

    Article  CAS  Google Scholar 

  16. Cohen EP, Lawton CA, Moulder JE . Bone marrow transplant nephropathy: radiation nephritis revisited Nephron 1995 70: 217 222

    Article  CAS  Google Scholar 

  17. Oyama Y, Komatsuda A, Imai H et al. Late onset bone marrow transplant nephropathy Intern Med 1996 35: 489 493

    Article  CAS  Google Scholar 

  18. Lawton CA, Cohen EP, Murray KJ et al. Long-term results of selective renal shielding in patients undergoing total body irradiation in preparation for bone marrow transplantation Bone Marrow Transplant 1997 20: 1069 1074

    Article  CAS  Google Scholar 

  19. Rabinowe SN, Soiffer RJ, Tarbell NJ et al. Hemolytic-uremic syndrome following bone marrow transplantation in adults for hematologic malignancies Blood 1991 77: 1837 1844

    CAS  Google Scholar 

  20. Dieterle A, Gratwohl A, Nizze H et al. Chronic cyclosporine-associated nephrotoxicity in bone marrow transplant patients Transplantation 1990 49: 1093 1100

    Article  CAS  Google Scholar 

  21. Miralbell R, Bieri S, Mermillod B et al. Renal toxicity after bone marrow transplantation: the combined effects of total-body irradiation and graft-versus-host disease J Clin Oncol 1996 14: 579 585

    Article  CAS  Google Scholar 

  22. Berg U, Bolme P . Renal function in children following bone marrow transplantation Transplant Proc 1989 21: 3092 3094

    CAS  Google Scholar 

  23. Moulder JE, Fish BL . Age dependence of radiation nephropathy in the rat Radiat Res 1997 147: 349 353

    Article  CAS  Google Scholar 

  24. Jacobson P, West N, Hutchinson RJ . Predictive ability of creatinine clearance estimate models in pediatric bone marrow transplantation Bone Marrow Transplant 1997 19: 481 485

    Article  CAS  Google Scholar 

  25. Gustafsson G, Kreuger A, Clausen N et al. Intensified treatment of acute childhood leukemia has improved prognosis, especially in non-high-risk patients: the Nordic experience of 2648 patients diagnosed between 1981 and 1996 Acta Paediatr Scand 1998 87: 1151 1161

    Article  CAS  Google Scholar 

  26. Lie SO, Jonmundsson G, Mellander L et al. A population-based study of 272 children with acute myeloid leukemia treated on two consecutive protocols with different intensity: best outcome in girls, infants, and children with Down's syndome Br J Haematol 1996 94: 82 88

    Article  CAS  Google Scholar 

  27. Lönnerholm G, Simonsson B, Arvidson J et al. Autologous bone marrow transplantation in children with acute lymphoblastic leukemia Acta Paediatr Scand 1992 81: 1017 1022

    Article  Google Scholar 

  28. Jones RJ, Lee KSK, Beschorner WE et al. Veno-occlusive disease of the liver following bone marrow transplantation Transplantation 1987 44: 778 783

    Article  CAS  Google Scholar 

  29. Schwartz GJ, Brion LP, Spitzer A . The use of plasma creatinine concentration for estimating glomerular filtration rate in infants, children, and adolescents Pediat Nephrol 1987 34: 571 590

    CAS  Google Scholar 

  30. Robbins MEC, Stephens LC, Thames HD et al. Radiation response of the monkey kidney following contralateral nephrectomy Int J Radiat Oncol Biol Phys 1994 30: 347 354

    Article  CAS  Google Scholar 

  31. Berns JS, Ford PA . Renal toxicities of antineoplastic drugs and bone marrow transplantation Semin Nephrology 1997 17: 54 66

    CAS  Google Scholar 

  32. Krochak RJ, Baker DG . Radiation nephritis. Clinical manifestations and pathophysiologic mechanisms Urology 1986 27: 389 393

    Article  CAS  Google Scholar 

  33. Luxton RW, Kunkler PB . Radiation nephritis Acta Radiol Ther Phys Biol 1964 2: 169 178

    Article  CAS  Google Scholar 

  34. Rybak MJ, Albrecht LM, Boike SC, Chandrasekar PH . Nephrotoxicity of vancomycin, alone and with an aminoglycoside J Antimicrob Chemother 1990 25: 679 687

    Article  CAS  Google Scholar 

  35. Moulder JE, Fish BL . Influence of nephrotoxic drugs on the late renal toxicity associated with bone marrow transplant conditioning regimens Int J Radiat Oncol Biol Phys 1991 20: 333 337

    Article  CAS  Google Scholar 

  36. Lawton CA, Fish BL, Moulder JE . Effect of nephrotoxic drugs on the development of radiation nephropathy after bone marrow transplantation Int J Radiat Oncol Biol Phys 1994 28: 883 889

    Article  CAS  Google Scholar 

  37. Niemer-Tucker MMB, Sluysmans MMJH, Bakker B et al. Long-term consequences of high-dose total-body irradiation on hepatic and renal function in primates Int J Radiat Biol 1995 68: 83 96

    Article  CAS  Google Scholar 

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Acknowledgements

This study was supported by the Children's Cancer Foundation in Sweden.

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Authors and Affiliations

  1. Uppsala University Children's Hospital, Uppsala, Sweden

    P Frisk & G Lönnerholm

  2. Department of Clinical Physiology, University Hospital, Uppsala, Sweden

    LE Bratteby

  3. Department of Medicine, University Hospital, Uppsala, Sweden

    K Carlson

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Frisk, P., Bratteby, L., Carlson, K. et al. Renal function after autologous bone marrow transplantation in children: a long-term prospective study. Bone Marrow Transplant 29, 129–136 (2002). https://doi.org/10.1038/sj.bmt.1703312

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