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Acute kidney injury in patients with newly diagnosed high-grade hematological malignancies: impact on remission and survival.


ABSTRACT:

Background

Optimal chemotherapy with minimal toxicity is the main determinant of complete remission in patients with newly diagnosed hematological malignancies. Acute organ dysfunctions may impair the patient's ability to receive optimal chemotherapy.

Design and methods

To compare 6-month complete remission rates in patients with and without acute kidney injury (AKI), we collected prospective data on 200 patients with newly diagnosed high-grade malignancies (non-Hodgkin lymphoma, 53.5%; acute myeloid leukemia, 29%; acute lymphoblastic leukemia, 11.5%; and Hodgkin disease, 6%).

Results

According to RIFLE criteria, 137 (68.5%) patients had AKI. Five causes of AKI accounted for 91.4% of cases: hypoperfusion, tumor lysis syndrome, tubular necrosis, nephrotoxic agents, and hemophagocytic lymphohistiocytosis. Half of the AKI patients received renal replacement therapy and 14.6% received suboptimal chemotherapy. AKI was associated with a lower 6-month complete remission rate (39.4% vs. 68.3%, P<0.01) and a higher mortality rate (47.4% vs. 30.2%, P<0.01) than patients without AKI. By multivariate analysis, independent determinants of 6-month complete remission were older age, poor performance status, number of organ dysfunctions, and AKI.

Conclusion

AKI is common in patients with newly diagnosed high-grade malignancies and is associated with lower complete remission rates and higher mortality.

SUBMITTER: Canet E 

PROVIDER: S-EPMC3573047 | biostudies-literature | 2013

REPOSITORIES: biostudies-literature

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Publications

Acute kidney injury in patients with newly diagnosed high-grade hematological malignancies: impact on remission and survival.

Canet Emmanuel E   Zafrani Lara L   Lambert Jerome J   Thieblemont Catherine C   Galicier Lionel L   Schnell David D   Raffoux Emmanuel E   Lengline Etienne E   Chevret Sylvie S   Darmon Michael M   Azoulay Elie E  

PloS one 20130214 2


<h4>Background</h4>Optimal chemotherapy with minimal toxicity is the main determinant of complete remission in patients with newly diagnosed hematological malignancies. Acute organ dysfunctions may impair the patient's ability to receive optimal chemotherapy.<h4>Design and methods</h4>To compare 6-month complete remission rates in patients with and without acute kidney injury (AKI), we collected prospective data on 200 patients with newly diagnosed high-grade malignancies (non-Hodgkin lymphoma,  ...[more]

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