INTERFERON-ALPHA-ASSOCIATED FOCAL SEGMENTAL GLOMERULOSCLEROSIS WITH MASSIVE PROTEINURIA IN PATIENTS WITH CHRONIC MYELOID-LEUKEMIA FOLLOWINGHIGH-DOSE CHEMOTHERAPY

BACKGROUND, Acute renal failure, with or without massive proteinuria, is a rare idiosyncratic toxicity of interferon (IFN)-alpha therapy. Th e authors sought to review their experience with this toxicity as well as the world literature on the subject. METHODS. The authors describe two patients with chronic myeloid leukemia treated with IFN-alpha fol lowing high dose chemotherapy who developed renal failure and proteinu ria after 3 and 4 weeks of IFN-alpha therapy, respectively. Fifteen pr eviously reported cases of renal failure and proteinuria associated wi th IFN-alpha therapy are also reviewed. RESULTS. Renal biopsies perfor med on the authors' two patients revealed focal segmental glomeruloscl erosis. However, the other reported patients with IFN-alpha associated renal failure and massive proteinuria had an assortment of pathologic findings. CONCLUSIONS. The specific renal pathology associated with p roteinuria may be a consequence of the condition and not its cause; di fferences in renal pathology may be caused by other predisposing facto rs. Patients treated with IFN-alpha following high dose chemotherapy, with or without autologous transplantation, should be followed for the development of proteinuria and renal failure. Cancer 1998;83: 1938-46 , (C) 1998 American Cancer Society.