Hematopoietic cell transplantation-related nephropathy in Japan

To clarify the incidence and characteristics of hematopoietic cell transpla ntation (HCT)-related nephropathy (HCT-N) in Japan, we sent questionnaire l etters to 188 hematologic divisions of 91 hospitals and analyzed the respon ses. Of 2,136 Japanese hematopoietic cell transplant recipients, 51 patient s (2.4%) had HCT-N, The early-onset (less than or equal to 30 days after HC T), middle-onset (31 to 120 days after HCT), and late-onset (>180 days afte r HCT) groups included 20, 16, and 15 patients, respectively. The early-ons et group mainly consisted of patients with acute renal failure (ARF) and he molytic uremic syndrome and/or thrombotic thrombocytopenic purpura, ARF was the dominant type in the middle-onset group. The main phenotype of the lat e-onset group was nephrotic syndrome, which correlated with chronic graft-v ersus-host disease (P = 0.008), The total amounts of irradiation for patien ts with chronic renal failure and urinary abnormality were significantly gr eater than those for patients with ARF (P = 0.004), The survival rate of th e early-onset and middle-onset groups was 47.2%, whereas 87% of patients in the late-onset group survived (P = 0.002), HCT-N is expected to become a s erious and important problem in Japan because of the increasing number of H CTs from unrelated donors. (C) 2000 by the National Kidney Foundation, Inc.