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Graft-Versus-Host Disease

Long-term renal function following bone marrow transplantation

Bone Marrow Transplantation volume 39, pages 717–723 (2007)Cite this article

Abstract

Renal function, evaluated as glomerular filtration rate (GFR) and effective renal plasma flow (ERPF), was investigated in 187 pediatric patients who underwent allogeneic (n=169) or autologous bone marrow transplantation (BMT). Allogeneic BMT patients were divided into three groups: hematological malignancies, aplastic anemia and non-malignant diseases, whereas autologous patients constituted a fourth group. A total of 64% received total body irradiation (TBI) as conditioning therapy, and 50 healthy children served as controls. GFR and ERPF were normal before transplantation. After 1 year, both GFR and ERPF were significantly reduced. GFR had recovered slightly after 3 years and remained stable thereafter. Recovery in ERPF was not apparent. Renal impairment was found in 41% of patients at 1 year, in 31% at 3 years and in 11% 7 years after BMT. Patients with hematological malignancies had lower GFRs than patients with non-malignant diseases at all time points. The most important risk factor as regards chronic renal impairment was TBI. Type of donor, cyclophosphamide (CY), or acute graft-versus-host disease (GVHD) did not seem to contribute to the development of chronic renal impairment. We suggest that tests of renal function should be included in long-term followup after BMT.

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Acknowledgements

We thank Elisabeth Berg for statistical support. This study was supported by the Barncancerfonden (The Swedish Childrens' Cancer Foundation), the Swedish Medical Research Foundation (no. 6864) and the Finnish Pediatric Research Foundation.

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Authors and Affiliations

  1. Department of Pediatrics, Turku University Central Hospital, Turku, Finland

    M H Grönroos

  2. Department of Clinical Science, Division of Pediatrics, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Sweden

    P Bolme, J Winiarski & U B Berg

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  1. M H Grönroos
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  2. P Bolme
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  4. U B Berg
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Correspondence to U B Berg.

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Grönroos, M., Bolme, P., Winiarski, J. et al. Long-term renal function following bone marrow transplantation. Bone Marrow Transplant 39, 717–723 (2007). https://doi.org/10.1038/sj.bmt.1705662

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