TY - JOUR
T1 - Nephrotic syndrome associated with tyrosine kinase inhibitors for pediatric malignancy
T2 - Case series and review of the literature
AU - Ruebner, Rebecca L.
AU - Copelovitch, Lawrence
AU - Evageliou, Nicholas F.
AU - Denburg, Michelle R.
AU - Belasco, Jean B.
AU - Kaplan, Bernard S.
PY - 2014/5
Y1 - 2014/5
N2 - Background: Tyrosine kinase (TK) inhibitors are increasingly being used to treat a variety of pediatric malignancies. Reports in adult patients describe a range of effects of TK inhibitors on the kidney, including hypertension, proteinuria, acute kidney injury, and thrombotic microangiopathy (TMA); however, there are only a few reports of TK-inhibitor-associated nephrotic syndrome. Methods: We report four pediatric patients with various malignancies (chronic myelogenous leukemia, acute lymphoblastic leukemia, and glioma/renal cell carcinoma) who developed nephrotic syndrome during treatment with TK inhibitors (imatinib, sunitinib, dasatinib, and quizartinib). One of the four patients also had clinical features of TMA. Results: Three of the four patients achieved complete remission of nephrotic syndrome with discontinuation of the TK inhibitor and have had no additional nephrotic syndrome relapses to date. The temporal relationship of nephrotic syndrome onset to TK-inhibitor therapy and resolution of nephrotic syndrome with cessation of therapy strongly imply an association in these patients. Conclusions: TK inhibitors are important therapies in pediatric cancer, and their use is expanding. Nephrotic syndrome with or without features of TMA is a potential complication of these therapies in children.
AB - Background: Tyrosine kinase (TK) inhibitors are increasingly being used to treat a variety of pediatric malignancies. Reports in adult patients describe a range of effects of TK inhibitors on the kidney, including hypertension, proteinuria, acute kidney injury, and thrombotic microangiopathy (TMA); however, there are only a few reports of TK-inhibitor-associated nephrotic syndrome. Methods: We report four pediatric patients with various malignancies (chronic myelogenous leukemia, acute lymphoblastic leukemia, and glioma/renal cell carcinoma) who developed nephrotic syndrome during treatment with TK inhibitors (imatinib, sunitinib, dasatinib, and quizartinib). One of the four patients also had clinical features of TMA. Results: Three of the four patients achieved complete remission of nephrotic syndrome with discontinuation of the TK inhibitor and have had no additional nephrotic syndrome relapses to date. The temporal relationship of nephrotic syndrome onset to TK-inhibitor therapy and resolution of nephrotic syndrome with cessation of therapy strongly imply an association in these patients. Conclusions: TK inhibitors are important therapies in pediatric cancer, and their use is expanding. Nephrotic syndrome with or without features of TMA is a potential complication of these therapies in children.
KW - Acute kidney injury
KW - Malignancy
KW - Nephrotic syndrome
KW - Thrombotic microangiopathy
KW - Tyrosine kinase inhibitors
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U2 - 10.1007/s00467-013-2696-0
DO - 10.1007/s00467-013-2696-0
M3 - Article
C2 - 24310825
AN - SCOPUS:84898902365
SN - 0931-041X
VL - 29
SP - 863
EP - 869
JO - Pediatric Nephrology
JF - Pediatric Nephrology
IS - 5
ER -