Focal segmental glomerulosclerosis: a very unusual complication of allogeneic hematopoietic cell transplantation (HCT).

摘要

Nephrotic syndrome (NS) is an extremely rare complication of hematopoietic cell transplantation (HCT) that usually occurs in association with chronic GVHD. Glomerular histology comprises mainly membranous ne-phropathy (MN) and minimal change disease. Conversely, focal segmental glomerulosclerosis (FSGS) is a very uncommon etiology of NS in patients undergoing HCT Here, we report the case of a 49-year-old white man with the diagnosis of AML-M1 with no chromosome abnormalities who received an allogeneic PBSC transplantation from his HLA-identical brother at the Department of Hematology of our Hospital, 4 months after achieving CR with chemotherapy (mitoxantrone, 12mg/m2; cytar-abine, 500mg/m2; etoposide, 200mg/m2). A reduced intensity conditioning (RIC) regimen consisting of fiudar-abine (30 mg/m2/day, 5 days), anti-thymocyte globulin (2mg/kg/day, 5 days), prednisone (2mg/kg/day, 5 days) and melphalan (60 mg/m2/day, days -3 and -2) was used. In addition, he received cyclosporin (5mg/kg/day, b.i.d.) and mycophenolate mofetil (2 g/day) for the prophylaxis of GVHD. Cyclosporin and mycophenolate mophetil were continued for 4 and 3 months, respectively.