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

机译:局灶性节段性肾小球硬化:同种异体造血细胞移植(HCT)的非常罕见的并发症。

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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.
机译:肾病综合征(NS)是造血细胞移植(HCT)的一种极为罕见的并发症,通常与慢性GVHD相关。肾小球组织学主要包括膜性肾病(MN)和微小变化疾病。相反,局部节段性肾小球硬化症(FSGS)在接受HCT的患者中非常罕见,是NS的病因。在这里,我们报道了一名49岁白人,患有AML-M1,无染色体异常,接受同种异体PBSC诊断接受化学疗法达到CR后4个月,由他在我医院血液科的HLA兄弟进行移植(米托蒽醌,12mg / m2;阿糖胞苷,500mg / m2;依托泊苷,200mg / m2)。降低强度的调理(RIC)方案,包括夫达阿滨(30 mg / m2 /天,5天),抗胸腺细胞球蛋白(2mg / kg /天,5天),泼尼松(2mg / kg /天,5天) )和美法仑(60 mg / m2 /天,第-3和-2天)。另外,他接受环孢菌素(5mg / kg /天,每日生)和霉酚酸酯(2g /天)用于预防GVHD。环孢菌素和霉酚酸酯分别持续4个月和3个月。

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