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Abstract: SA-PO0199

Clinical Outcomes of De Novo Membranous Nephropathy Following Allogeneic Hematopoietic Stem Cell Transplantation

Session Information

Category: Onconephrology

  • 1700 Onconephrology

Authors

  • Won, Alice H., Memorial Sloan Kettering Cancer Center, New York, New York, United States
  • Glezerman, Ilya, Memorial Sloan Kettering Cancer Center, New York, New York, United States
  • Seshan, Surya V., Weill Cornell Medicine, New York, New York, United States
  • Shaikh, Aisha, University of Pennsylvania, Philadelphia, Pennsylvania, United States
Background

De novo glomerular diseases are rare following allogeneic hematopoietic stem cell transplantation (HSCT) with an overall reported incidence of 1-2%. Membranous Nephropathy (MN) is the most common cause of nephrotic-range proteinuria in this patient population. Due to the rarity of this condition, the treatment protocols for post-HSCT MN are not well defined.

Methods

We retrospectively assessed the clinical outcomes of adult patients with de novo MN following allogeneic HSCT at a single tertiary care cancer center in the United States, during 2010-2025.

Results

13 patients were diagnosed with kidney-biopsy proven de novo MN following allogeneic HSCT. Of the 13 patients, 2 patients did not receive immunosuppression (IS) and 11 patients received IS. Of the 11 patients who received IS, 4 received calcineurin inhibitor (CNI) plus corticosteroids (CS), 2 received CNI + CS + rituximab, 2 received CNI plus rituximab, 2 received rituximab alone, and 1 patient received a CNI alone. Two patients were excluded from the analysis due to early death, and one was excluded due to insufficient follow-up time. The remaining 10 patients achieved either CR or PR, including the patients who did not receive any IS. However, time to CR or PR was longer among patients who did not receive IS compared to patients who received IS (30 months vs. 13 months). None of the patients who received rituximab-based IS experienced a renal relapse. However, 4 patients experienced a relapse following non-rituximab-based IS.

Conclusion

Our study suggests that clinical remission can be successfully achieved in post-HSCT MN with a variety of therapies, however rituximab-based therapy may be associated with fewer MN relapses. Future larger studies are needed to assess the optimal treatment for post-HSCT MN.

Summary of clinical outcomes of de novo membranous nephropathy following allogeneic hematopoietic stem cell transplantation

Digital Object Identifier (DOI)