{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T13:02:27Z","timestamp":1784120547517,"version":"3.55.0"},"reference-count":41,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T00:00:00Z","timestamp":1662940800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Immunol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Due to the various clinical and pathological manifestations of kidney involvement in lymphoproliferative disorder (LPD), the whole spectrum of kidney disease in LPD is still unclear, and data on kidney prognosis is scarce.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrospectively reviewed the renal pathology profiles from January 2010 to December 2021, and 28 patients with B-cell LPD combined with intact renal biopsy data were included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were 20 men and eight women aging 41 to 79 years at the time of renal biopsy (median age 62 years). According to hematological diagnosis, patients were classified into four groups: chronic lymphocytic leukemia (CLL) (group1, n=7), Waldenstr\u00f6m macroglobulinemia\/lymphoplasmacytic lymphoma (WM\/LPL) (group 2, n=8; WM, n=6; LPL, n=2), Other non-Hodgkin\u2019s lymphomas (NHL) (group3, n=7; diffuse large B-cell lymphoma (DLBCL), n=2; mucosa-associated lymphoid tissue (MALT) lymphoma, n=4; Low grade B-cell lymphoma, n=1), and monoclonal gammopathy of undetermined significance\/monoclonal gammopathy of renal significance (MGUS\/MGRS) (group 4, n=6). Median serum creatinine (Scr) level was 129 (range,59-956) umol\/L. Eight patients (29%) were presented with acute kidney injury (AKI), and five patients (18%) required hemodialysis upon admission. Twenty-three patients (82%) presented with proteinuria (median protein excretion, 2.14 g\/d), 11(39%) of whom had the nephrotic syndrome. Interstitial malignant infiltration was the most frequent renal lesion (n=6). Eight patients underwent immunohistochemistry of renal tissues, of which three patients (CLL, n=1; LPL, n=1; WM, n=1) had confirmed lymphoma infiltrates, and the infiltrating cells in the remaining five patients (CLL, n=1; MALT lymphoma, n=2; MGUS, n=2) were considered unrelated to lymphoma. The most common glomerular diseases were renal amyloidosis (n=4) and membranous nephropathy (n=4). Only 20 patients were treated, 13 of whom were treated with rituximab separately or in combination. The median follow-up time was 11 months. Of these, six had achieved hematological response, complete response in five cases. Eight had achieved renal response. At the end-of-study visit, four patients died and two progressed to end stage kidney disease (ESKD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In conclusion, the clinicopathological spectrum of renal involvement in BLPD is diverse. Renal biopsy and immunohistochemistry are required for early diagnosis and prognostic assessment.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fimmu.2022.903315","type":"journal-article","created":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T04:47:51Z","timestamp":1662958071000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":13,"title":["Clinicopathological features and individualized treatment of kidney involvement in B-cell lymphoproliferative disorder"],"prefix":"10.3389","volume":"13","author":[{"given":"Guangyan","family":"Nie","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianqin","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chengning","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanggang","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huijuan","family":"Mao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhen","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianyong","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suyan","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Changying","family":"Xing","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,9,12]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1016\/j.lpm.2019.07.022","article-title":"Histopathological classification of chronic b-lymphoproliferative disorders","author":"Bontoux","year":"2019","journal-title":"Presse Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1038\/nrneph.2011","article-title":"The pathogenesis and diagnosis of acute kidney injury in multiple myeloma","volume":"8","author":"Hutchison","year":"2011","journal-title":"Nat Rev Nephrol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.13041117","article-title":"Kidney involvement of patients with waldenstr\u00f6m macroglobulinemia and other IgM-producing b cell lymphoproliferative disorders","volume":"13","author":"Higgins","year":"2018","journal-title":"Clin J Am Soc Nephrol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-07-445304","article-title":"Monoclonal gammopathy of renal significance: when MGUS is no longer undetermined or insignificant","volume":"120","author":"Leung","year":"2012","journal-title":"Blood"},{"key":"B5","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1038\/s41581-018-0077-4","article-title":"The evaluation of monoclonal gammopathy of renal significance: a consensus report of the international kidney and monoclonal gammopathy research group","volume":"15","author":"Leung","year":"2019","journal-title":"Nat Rev Nephrol"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2006.01.004","article-title":"Marked recovery of severe renal lesions in POEMS syndrome with high-dose melphalan therapy supported by autologous blood stem cell transplantation","volume":"47","author":"Sanada","year":"2006","journal-title":"Am J Kidney Dis"},{"key":"B7","doi-asserted-by":"publisher","first-page":"698","DOI":"10.1038\/ki.2014.408","article-title":"Diagnosis of monoclonal gammopathy of renal significance","volume":"87","author":"Bridoux","year":"2015","journal-title":"Kidney Int"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3390\/cancers12071741","article-title":"Monoclonal gammopathies of renal significance: Renal biopsy and beyond","volume":"12","author":"Men\u00e8","year":"2020","journal-title":"Cancers (Basel)"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2011.041277","article-title":"Diffuse large b-cell lymphoma with involvement of the kidney: outcome and risk of central nervous system relapse","volume":"96","author":"Villa","year":"2011","journal-title":"Haematologica"},{"key":"B10","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1016\/j.kint.2019.01.027","article-title":"Clinicopathological spectrum of renal parenchymal involvement in b-cell lymphoproliferative disorders","volume":"96","author":"Javaugue","year":"2019","journal-title":"Kidney Int"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2016-01-643569","article-title":"The 2016 revision of the world health organization classification of lymphoid neoplasms","volume":"127","author":"Swerdlow","year":"2016","journal-title":"Blood"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-09-454355","article-title":"MYD88 L265P in waldenstr\u00f6m macroglobulinemia, immunoglobulin m monoclonal gammopathy, and other b-cell lymphoproliferative disorders using conventional and quantitative allele-specific polymerase chain reaction","volume":"12111","author":"Xu","year":"2013","journal-title":"Blood"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-06-436329","article-title":"MYD88 L265P mutation in waldenstrom macroglobulinemia","volume":"121","author":"Poulain","year":"2013","journal-title":"Blood"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1053\/sonc.2003.50082","article-title":"Clinicopathological definition of waldenstrom's macroglobulinemia: consensus panel recommendations from the second international workshop on waldenstrom's macroglobulinemia","volume":"30","author":"Owen","year":"2003","journal-title":"Semin Oncol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2009-03-209262","article-title":"The 2008 revision of the world health organization (WHO) classification of myeloid neoplasms and acute leukemia: rationale and important changes","volume":"114","author":"Vardiman","year":"2009","journal-title":"Blood"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.37.7614","article-title":"New criteria for response to treatment in immunoglobulin light chain amyloidosis based on free light chain measurement and cardiac biomarkers: impact on survival outcomes","volume":"30","author":"Palladini","year":"2012","journal-title":"J Clin Oncol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1111\/bjh.12102","article-title":"Response assessment in waldenstr\u00f6m macroglobulinaemia: update from the VIth international workshop","volume":"160","author":"Owen","year":"2013","journal-title":"Br J Haematol"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.09.2403","article-title":"Revised response criteria for malignant lymphoma","volume":"25","author":"Cheson","year":"2007","journal-title":"J Clin Oncol"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2007-06-093906","article-title":"Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: a report from the international workshop on chronic lymphocytic leukemia updating the national cancer institute-working group 1996 guidelines","volume":"111","author":"Hallek","year":"2008","journal-title":"Blood"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-150-9-200905050-00006","article-title":"A new equation to estimate glomerular filtration rate","volume":"150","author":"Levey","year":"2009","journal-title":"Ann Intern Med"},{"key":"B21","doi-asserted-by":"publisher","first-page":"R31","DOI":"10.1186\/cc5713","article-title":"Acute kidney injury network: report of an initiative to improve outcomes in acute kidney injury","volume":"11","author":"Mehta","year":"2007","journal-title":"Crit Care"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-7599.2002.tb00119.x","article-title":"K\/DOQI clinical practice guidelines for chronic kidney disease: evaluation, classification, and stratification","volume":"39","year":"2002","journal-title":"Am J Kidney Dis"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.3390\/ijms23105570","article-title":"MYD88 mutations: Transforming the landscape of IgM monoclonal gammopathies","volume":"23","author":"Alcoceba","year":"2022","journal-title":"Int J Mol Sci"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0095190","article-title":"Renal involvement in non-Hodgkin lymphoma: proven by renal biopsy","volume":"9","author":"Li","year":"2014","journal-title":"PloS One"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1309\/AJCP7YLTQPUSDQ5C","article-title":"Distribution of lymphoid neoplasms in China: analysis of 4,638 cases according to the world health organization classification","volume":"138","author":"Sun","year":"2012","journal-title":"Am J Clin Pathol"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2015.03.035","article-title":"Kidney diseases associated with monoclonal immunoglobulin m-secreting b-cell lymphoproliferative disorders: a case series of 35 patients","volume":"66","author":"Chauvet","year":"2015","journal-title":"Am J Kidney Dis"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.01600408","article-title":"Renal lesions associated with IgM-secreting monoclonal proliferations: revisiting the disease spectrum","volume":"3","author":"Audard","year":"2008","journal-title":"Clin J Am Soc Nephrol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1016\/j.ekir.2021.04.026","article-title":"A fresh perspective on monoclonal gammopathies of renal significance","volume":"6","author":"Aucouturier","year":"2021","journal-title":"Kidney Int Rep"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2016","article-title":"Paraprotein-associated thrombotic microangiopathy: expanding the spectrum of renal disease related to plasma cell dyscrasias","volume":"91","author":"Lin","year":"2017","journal-title":"Kidney Int"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1007\/s11255-018-1896-8","article-title":"Which should be the correct treatment for monoclonal gammopathy of renal significance with complement alternative pathway dysregulation (C3 glomerulopathy and atypical hemolytic uremic syndrome): clone-directed or anticomplement therapy","volume":"50","author":"Ciocchini","year":"2018","journal-title":"Int Urol Nephrol"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2021.780107","article-title":"Thrombotic microangiopathy, an unusual form of monoclonal gammopathy of renal significance: Report of 3 cases and literature review","volume":"12","author":"Filippone","year":"2021","journal-title":"Front Immunol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"516","DOI":"10.1016\/j.kint.2017.04.039","article-title":"Complement-dependent, monoclonal gammapathy-associated thrombotic microangiopathy","volume":"92","author":"Schurder","year":"2017","journal-title":"Kidney Int"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2016.09.045","article-title":"Thrombotic microangiopathy associated with monoclonal gammopathy","volume":"91","author":"Ravindran","year":"2017","journal-title":"Kidney Int"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.25569","article-title":"Monoclonal gammopathy-associated thrombotic microangiopathy","volume":"94","author":"Yui","year":"2019","journal-title":"Am J Hematol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.23412","article-title":"Monoclonal gammopathy of renal significance (MGRS) increases the risk for progression to multiple myeloma: an observational study of 2935 MGUS patients","volume":"9","author":"Steiner","year":"2017","journal-title":"Oncotarget"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1007\/s10157-007-0009-2","article-title":"IgA nephropathy associated with leukemia and lymphoma: report of two cases","volume":"12","author":"Motoyama","year":"2008","journal-title":"Clin Exp Nephrol."},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.56.7315","article-title":"Angioimmunoblastic T-cell lymphoma associated with IgA nephropathy","volume":"56","author":"Harada","year":"2017","journal-title":"Intern Med"},{"key":"B38","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2004.09.007","article-title":"IgA nephropathy and hodgkin's disease: a rare coincidence","volume":"45","author":"Bergmann","year":"2005","journal-title":"Case Rep lit rev. Am J Kidney Dis"},{"key":"B39","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.1998.v31.pm9531192","article-title":"Successful treatment of IgA nephropathy in association with low-grade b-cell lymphoma of the mucosa-associated lymphoid tissue type","volume":"31","author":"Mak","year":"1998","journal-title":"Am J Kidney Dis"},{"key":"B40","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2007121303","article-title":"CD19+CD5+ b cells in primary IgA nephropathy","volume":"19","author":"Yuling","year":"2008","journal-title":"J Am Soc Nephrol."},{"key":"B41","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajkd.2003.08.004","article-title":"Lymphomas diagnosed by percutaneous kidney biopsy","volume":"42","author":"T\u00f6rnroth","year":"2003","journal-title":"Am J Kidney Dis"}],"container-title":["Frontiers in Immunology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2022.903315\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,9,12]],"date-time":"2022-09-12T04:47:54Z","timestamp":1662958074000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fimmu.2022.903315\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,9,12]]},"references-count":41,"alternative-id":["10.3389\/fimmu.2022.903315"],"URL":"https:\/\/doi.org\/10.3389\/fimmu.2022.903315","relation":{},"ISSN":["1664-3224"],"issn-type":[{"value":"1664-3224","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,9,12]]},"article-number":"903315"}}