Dzhumabaeva B T, Biryukova L S, Golitsyna E P, Varshavsky V A
Hematology Research Center, Ministry of Health of Russia, Moscow, Russia.
I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia, Moscow, Russia.
Ter Arkh. 2015;87(12):85-88. doi: 10.17116/terarkh2015871285-88.
Chronic lymphocytic leukemia (CLL) in association with glomerulonephritis (GN) and renal failure is a serious problem in terms of therapy. The paper reports a clinical case of a 64-year-old female patient with Binet stage C CLL accompanied by minimal-change GN complicated by nephrotic syndrome and the development of acute renal failure. GN was diagnosed on the basis of electron microscopic studies of renal biopsy specimens. It was treated with rituximab in combination with bendamustine. The former was intravenously injected in a dose of 375 mg/m2 on day 0 of the cycle; the latter was given in a dose of 70 mg/m2 within the first 2 days; the cycle was repeated 28 days after initiation of the previous cycle. Five cycles could result in complete CLL remission (the follow-up duration was 20 months); nephrotic syndrome was completely abolished and kidney function recovered.
慢性淋巴细胞白血病(CLL)合并肾小球肾炎(GN)和肾衰竭在治疗方面是一个严重问题。本文报道了一例64岁女性患者的临床病例,该患者为Binet C期CLL,伴有微小病变型GN,并发肾病综合征及急性肾衰竭。GN是根据肾活检标本的电子显微镜检查确诊的。采用利妥昔单抗联合苯达莫司汀进行治疗。前者在周期第0天静脉注射,剂量为375mg/m²;后者在最初2天内给予,剂量为70mg/m²;前一周期开始28天后重复该周期。五个周期后CLL完全缓解(随访期为20个月);肾病综合征完全消除,肾功能恢复。