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KMID : 0366220060410030199
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Korean Journal of Hematology
2006 Volume.41 No. 3 p.199 ~ p.203
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A Case of Acute Lymphoblastic Leukemia in a Patient with Minimal Change Nephrotic Syndrome
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Kim Il-Young
Moon Ji-Yoon
Song Moo-Kon
Ahn Yong-Sung
Kim Kyung-Yup
Choi Young-Jin
Shin Ho-Jin
Chung Joo-Seop
Cho Goon-Jae
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Abstract
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We experienced a 22-year old patient with a documented history of minimal change nephrotic syndrome (MCNS), and a diagnosis of acute lymphoblastic leukemia (ALL) was then made for this patient. The patient received standard daily steroid therapy for the treatment of nephrotic syndrome. Cyclosporin A was administered because there was no clinical improvement with steroid therapy. Six years after the diagnosis of nephrotic syndrome, the patient was diagnosed with ALL. After chemotherapy for ALL, the patient was in complete remission and he showed clinical improvement of nephrotic syndrome. The hematological malignancies associated with nephrotic syndrome are mainly lymphoma and chronic lymphocytic leukemia. ALL has rarely been described in combination with nephrotic syndrome. Although the exact mechanism for development of ALL after nephrotic syndrome is unknown, at least two possibilities exist. First, the incidence of leukemia may be increased after immunosuppressive therapy, which may include cyclosporin A. Second, the underlying defect in T-lymphocyte function could account for both nephrotic syndrome and ALL. The possible mechanisms for such a relationship are discussed here along with a review of the relevant literature.
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KEYWORD
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Acute lymphoblastic leukemia, Nephrotic syndrome, Cyclosporin A
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