GLOMERULAR INJURY IN CHRONIC MYELOMONOCYTIC LEUKEMIA

Among 825 cases of de novo myelodysplastic syndromes (MDS) diagnosed o ver a period of 13 years in our center, 4 had clinically significant g lomerulopathy. All 4 fulfilled diagnostic criteria of chronic myelomon ocytic leukemia (CMML), and could be classified in the low or intermed iate risk groups according to two scoring systems. Presenting symptoms of renal involvement were edema in 3 cases and acute renal failure in the remaining patient. Three patients had the nephrotic syndrome. Ren al biopsy (performed in 2 cases but considered as contraindicated in t he other cases) showed AL amyloidosis on one case and extracapillary g lomerulonephritis in the other case. The 4 patients were treated with V16 or hydroxyurea and two had renal improvement. Only one previous ca se of MDS associated with glomerulopathy has been reported before and also very probably had CMML. This, and the response of renal disease t o chemotherapy in 2 of our patients suggests a possible relationship b etween the two disorders. More systematic investigation of glomerular function, in CMML, could possibly disclose a higher incidence of cases of glomerular injury in this type of MDS.