Kidney Complications Are Heterogenous in CMML

A study published in Kidney International Reports found heterogeneity with respect to kidney complications associated with chronic myelomonocytic leukemia (CMML) and BCR-ABL-negative myeloproliferative neoplasms (MPNs).

In this case series, researchers assessed 18 patients with myeloid neoplasms (CMML, n=8; essential thrombocytosis [ET], n=7; polycythemia vera [PV], n=1; myelofibrosis, n=2) who were diagnosed with acute kidney injury (AKI), chronic kidney disease (CKD), or urine abnormalities. Thirteen of 18 patients were male.

The results of the analysis showed that 12 patients had AKI at presentation, while eight patients had glomerular presentation. The results of kidney biopsy in 14 patients showed heterogeneity, including pauci-immune glomerulosclerosis (n=5), extramedullary hematopoiesis (n=6), or tubular atrophy and interstitial fibrosis with polymorphic inflammation (n=8).

Subsequent to a follow-up of about two years, malignancy was considered stable in 61% of the study population, but 22% of patients had progressed to end-stage renal failure. The remaining patients had persistently reduced kidney function, the researchers noted. They did not observe a correlation between the malignancy and renal presentation and outcomes

“Kidney complications of CMML/MPN are heterogenous, and kidney biopsy may help to identify new molecular targets to prevent the development of kidney fibrosis,” the researchers concluded.