Primary renal diffuse large B-cell lymphoma presenting as new-onset kidney failure

Article Article scientifique Article Primary renal diffuse large B-cell lymphoma presenting as new-onset kidney failure eng 2025-06-10 author Bertacchi Massimiliano 0000-0001-5861-4505 Division of Pediatric Nephrology, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland. massimiliano.bertacchi@gmail.com. 935630 author Vasey Léa Division of General Pediatrics, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland. 807205 author Wilhelm-Bals Alexandra Marina Division of Pediatric Nephrology, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland. 105558 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) author Rougemont-Pidoux Anne-Laure Division of Clinical Pathology, Diagnostic Department, Geneva University Hospitals, Geneva, Switzerland. 29140 Département de pathologie et immunologie (PATIM) author Baleydier Frédéric Division of Pediatric Oncology and Hematology, Department of Paediatrics, Gynaecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland.,CANSEARCH Research Platform for Pediatric Oncology and Hematology, Department of Pediatrics, Gynecology, and Obstetrics, Faculty of Medicine, University of Geneva, Geneva, Switzerland. 987669 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) author Parvex Paloma Maria Division of Pediatric Nephrology, Department of Pediatrics, Gynecology and Obstetrics, Geneva University Hospitals, Geneva, Switzerland. 36046 Département de Pédiatrie, Gynécologie et Obstétrique (PETRI) 10.1007/s00467-025-06833-y 40493263 0931-041X https://link.springer.com/article/10.1007/s00467-025-06833-y Background: Primary renal lymphoma is a rare form of kidney tumor, accounting for less than 1% of all kidney masses, and with only a few pediatric cases reported in the literature. Bilateral forms can present with kidney failure, constituting a therapeutic challenge for both hematologists and nephrologists, with the need to combine complex chemotherapy regimens and kidney replacement therapy. Methods: We present a rare case of primary bilateral renal diffuse large B-cell lymphoma in a teenage girl presenting with kidney failure (eGFR of 7 ml/min/1.73 m2 ), proposing a practical approach to optimize chemotherapy on kidney replacement therapy. We discuss diagnostic methods, the management and adjustment of chemotherapy and hyperhydration protocols, and the tailoring of highly efficient hemodiafiltration sessions to grant sufficient drug exposure while avoiding drug accumulation and toxicity in the context of kidney failure. Results: This approach permitted a substantial reduction of chemotherapy adverse effects while inducing remission and partial recovery of kidney function in our patient, with hemodialysis discontinuation after 6 months, and an eGFR that had improved to 28 ml/min/1.73 m2 at 12 months. Conclusions: Managing complex chemotherapy protocols in kidney failure can be challenging, and the collaboration of a multidisciplinary team is essential. The adjustment of drug dosing and the tailoring of hemodialysis can increase patients' tolerance while maintaining chemotherapy efficiency. Dialysis Personalized medicine Pharmacology Primary renal lymphoma Dewey 616.07 Dewey 618 137 Département de pathologie et immunologie 21F 58 Département de pédiatrie, gynécologie et obstétrique 223 false 564 Oncologie et hématologie pédiatriques 907 Pediatric nephrology f77305d8-c964-4527-a4d3-2db35d501b3b Article (Published version) Public Article_scientifique_from_unpaywall.pdf 1096378 application/pdf CC BY-4.0 c4b12bf99083ecaf2792db64acaf56fc8b1ee0707c56f8b906ebc6a2bc1216a7 803671d2-bda0-4657-9a58-a42935897979 Supplemental data Public 467_2025_6833_MOESM1_ESM.pptx 164851 application/vnd.openxmlformats-officedocument.presentationml.presentation Graphical abstract 6f223cfdd99aa8328323d716392b32c058f124690f60263bd6e9f448899ffde1 e3cb2915-33a1-472b-9d20-09a1283519fd Supplemental data Public 467_2025_6833_MOESM2_ESM.docx 20990 application/vnd.openxmlformats-officedocument.wordprocessingml.document 954ffa80195a76300eeec904acf36f24b276392a4e76ff66de101e210e5c8fd9 Vignette Public 467_2025_6833_MOESM1_ESM - Copie.jpg 277732 image/png openAccess Faculté de médecine / Section de médecine fondamentale / Département de pathologie et immunologie Faculté de médecine / Section de médecine clinique / Département de pédiatrie, gynécologie et obstétrique

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Primary renal diffuse large B-cell lymphoma presenting as new-onset kidney failure	Pediatric nephrology			2025	41	91

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Vasey, Léa