Comparison of clinical features of nephrotic syndrome after haploidentical and matched donor hematopoietic stem cell transplantation

• Published in: Chinese medical journal Vol. 137; no. 4; pp. 478 - 480
• Main Authors: Sun, Wei, Zhang, Yuanyuan, Chen, Yuhong, Sun, Yuqian, Cheng, Yifei, Wang, Fengrong, Chen, Huan, Chen, Yao, Yan, Chenhua, Mo, Xiaodong, Han, Wei, Xu, Lanping, Wang, Yu, Zhang, Xiaohui, Liu, Kaiyan, Huang, Xiaojun
• Format: Journal Article
• Language: English
• Published: China Lippincott Williams & Wilkins Ovid Technologies 20.02.2024; Lippincott Williams & Wilkins; Wolters Kluwer
• Subjects: Correspondence; Cytomegalovirus; Graft versus host disease; Graft vs Host Disease; Hematology; Hematopoietic Stem Cell Transplantation; Humans; Kidney diseases; Leukemia; Nephrotic Syndrome; Neutrophils; Patients; Stem cell transplantation; Tissue Donors; Transplantation Conditioning
• ISSN: 0366-6999; 2542-5641
• DOI: 10.1097/CM9.0000000000002795

Characteristics HID allo-HSCT (n = 16) MD allo-HSCT (n = 25) Statistical value P value Age at HSCT (years) 35 (7–59) 40 (9–62) 187.500 0.748* Patient sex (male/female) 12 (75.0)/4 (25.0) 18 (72.0)/7 (28.0) 0.042 0.833† Diagnosis 4.500 0.467† ALL 3 (18.8) 4 (16.0) AML 7 (43.8) 11 (44.0) PCL 1 (6.3) 0 ABL 0 1 (4.0) MPN 2 (12.5) 3 (12.0) MDS 1 (6.3) 5 (20.0) AA 2 (12.5) 1 (4.0) 24-h urine protein at diagnosis (g) 6.2 ± 3.3 12.4 ± 12.8 101.000 0.009* Serum albumin at diagnosis of NS (g/L) 25.4 ± 4.0 20.2 ± 6.1 93.000 0.004* Number of cases who underwent renal biopsy 6 (37.5) 19 (76.0) 6.100 0.014† Conditioning regimen containing ATG 16 (100.0) 6 (24.0) 22.700 <0.001† Time from HSCT to neutrophil engraftment (days) 15 (11–22) 13 (10–19) 132.000 0.138* Time from HSCT to platelet engraftment (days) 19 (8–70) 13 (8–73) 104.000 0.042* aGVHD 12 (75.0) 5 (20.0) 12.200 <0.001† cGVHD 14 (87.5) 24 (96.0) 1.000 0.308† CMV infection 12 (75.0) 9 (36.0) 5.900 0.015† Data are presented as median (range), n (%) or mean ± standard deviation. There were no significant differences between NS and control groups in median age, patient sex, donor sex, disease diagnosis, transplantation type, and follow-up time (all P >0.05), as shown in Supplementary Table 2, http://links.lww.com/CM9/B660. Večerić-Haler et al[5] demonstrated that ATG followed by mesenchymal stem cell transplantation significantly improved injured renal function in mice. Since HID HSCT recipients had a higher proportion of ATG in their conditioning regimen, we speculated that ATG might protect the kidney and that the difference in the frequency and clinical manifestations of NS between HID and MD HSCT patients might be related to the different conditioning regimens. Previous literature believed that cGVHD was the main cause of NS. Since aGVHD and TMA mainly occurred in the early stage after transplantation, this also explained the fact that the onset time of NS for HID