Long-term kidney complications in childhood leukemia survivors: a study from the Childhood and Adolescent Leukaemia (LEA) project

Acute leukemias represent the first cause of cancer in children. Their prognosis has improved significantly due to remarkable advances in therapeutic management, despite the risk of long-term consequences, especially for patients who underwent allogenic hematopoietic stem cell transplantation (aHSCT). Through the Leukemia in Children and Adolescents (LEA) long-term follow-up cohort (clinicaltrials gov. Identifier: NCT01756599), we conducted a French national multicenter prospective study on the occurrence and risk factors of chronic kidney disease (CKD), differentiating glomerular and tubular dysfunctions, corresponding to the NephroLEA project. Among the 1,676 patients included, the median age at evaluation was 15.8 (interquartile range [IQR], 11.3-20.5) years, with a median follow-up of 9.2 (IQR, 5.8-13.9) years. aHSCT was performed on 343 (20.6%) patients, half of whom have undergone the procedure after achieving second or greater remission. A higher percentage of children among transplanted patients had diastolic and systolic blood pressure above the 95th, with 13.7% versus 5.2% (P=3x10-3) and 15% versus 6.5% (P=9x10-2), respectively. A total of 187 patients (11.1%) had a mild CKD (i.e., eGFR between 75 and 90 mL/min/1.73 m2), while 3% (N=50) exhibited mild to severe CKD (eGFR <75 mL/min/1.73 m2). Notably, no patient reached kidney failure. Twenty-one patients (1.3%) had decreased glomerular filtration rate associated with tubular impairment. The principal risk factors for developing CKD were aHSCT and leukemia relapse. In conclusion, CKD represents a long-term risk for patients who relapsed and/or underwent aHSCT. These patients could benefit from nephroprotection advice to further improve their long-term outcomes, which is becoming a public health issue.

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Publication Details

Journal
Haematologica
Published
2025-04-03
DOI
https://doi.org/10.3324/haematol.2024.286940
Citations
1
Primary Topic
Acute Lymphoblastic Leukemia research
Type
article
Field-Weighted Citation Impact
1.88
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article

Long-term kidney complications in childhood leukemia survivors: a study from the Childhood and Adolescent Leukaemia (LEA) project

Isabelle Pellier, Alexandre Théron, Pascal Chastagner, Jean‐Hugues Dalle et al.
1 citations
Haematologica
Acute Lymphoblastic Leukemia research
1.88
article

Long-term kidney complications in childhood leukemia survivors: a study from the Childhood and Adolescent Leukaemia (LEA) project

Isabelle Pellier, Alexandre Théron, Pascal Chastagner, Jean‐Hugues Dalle, Laurence Derain‐Dubourg, Justine Bacchetta, Marilyne Poirée, Zeinab Hamidou, Marlène Pasquet, Dominique Plantaz, Stéphane Ducassou, Paul Saultier, Sandrine Thouvenin, Carine Domenech, Virginie Gandemer, Marie‐Dominique Tabone, André Baruchel, Pascal Auquier, Justyna Kanold, Gérard Michel, Yves Reguerres
article en
1 citations

Abstract

Acute leukemias represent the first cause of cancer in children. Their prognosis has improved significantly due to remarkable advances in therapeutic management, despite the risk of long-term consequences, especially for patients who underwent allogenic hematopoietic stem cell transplantation (aHSCT). Through the Leukemia in Children and Adolescents (LEA) long-term follow-up cohort (clinicaltrials gov. Identifier: NCT01756599), we conducted a French national multicenter prospective study on the occurrence and risk factors of chronic kidney disease (CKD), differentiating glomerular and tubular dysfunctions, corresponding to the NephroLEA project. Among the 1,676 patients included, the median age at evaluation was 15.8 (interquartile range [IQR], 11.3-20.5) years, with a median follow-up of 9.2 (IQR, 5.8-13.9) years. aHSCT was performed on 343 (20.6%) patients, half of whom have undergone the procedure after achieving second or greater remission. A higher percentage of children among transplanted patients had diastolic and systolic blood pressure above the 95th, with 13.7% versus 5.2% (P=3x10-3) and 15% versus 6.5% (P=9x10-2), respectively. A total of 187 patients (11.1%) had a mild CKD (i.e., eGFR between 75 and 90 mL/min/1.73 m2), while 3% (N=50) exhibited mild to severe CKD (eGFR <75 mL/min/1.73 m2). Notably, no patient reached kidney failure. Twenty-one patients (1.3%) had decreased glomerular filtration rate associated with tubular impairment. The principal risk factors for developing CKD were aHSCT and leukemia relapse. In conclusion, CKD represents a long-term risk for patients who relapsed and/or underwent aHSCT. These patients could benefit from nephroprotection advice to further improve their long-term outcomes, which is becoming a public health issue.

HaematologicaVol. 110(9)
Université Claude Bernard Lyon 1 (FR), Centre National de la Recherche Scientifique (FR), Université de Bordeaux (FR), Lyon College (US), Université de Montpellier (FR), Université Paris Cité (FR), Aix-Marseille Université (FR), University of Reunion Island (RE), Centre Hospitalier Universitaire de Grenoble (FR), Centre Hospitalier Universitaire de Bordeaux (FR), Université Rennes 2 (FR), Sorbonne Université (FR), Hôpital Armand-Trousseau (FR), Centre Hospitalier Universitaire de La Réunion (RE), Institut d’Hématologie et d’Oncologie Pédiatrique (FR), Sorbonne Paris Cité (FR), Centre Hospitalier Universitaire de Montpellier (FR), Institute for Regenerative Medicine & Biotherapy (FR), Assistance Publique – Hôpitaux de Paris (FR), Hospices Civils de Lyon (FR), University of Clermont Auvergne (FR), Hôpital d'Enfants (FR), Centre de Recherche en Automatique de Nancy (FR), Hôpital Pellegrin (FR), Centre Hospitalier Universitaire d'Angers (FR), Hôpital l'Archet (FR), Center for Assessment (US), Hôpital Edouard Herriot (FR), Hôpital Robert-Debré (FR), Centre Hospitalier Universitaire de Clermont-Ferrand (FR), Hôpital Purpan (FR), Centre Hospitalier Universitaire de Rennes (FR), Laboratoire de Biologie Tissulaire et d'Ingénierie Thérapeutique (FR), Centre Hospitalier Universitaire de Saint-Étienne (FR), Écologie Marine Tropicale des Océans Pacifique et Indien (RE), Hôpital de la Timone (FR), Université d'Angers (FR), Université Grenoble Alpes (FR), Université de Lorraine (FR)
Good health and well-being
Openalex Percentile: Top 17%
Acute Lymphoblastic Leukemia research
1.88
DOIOpen Access PDFOpenAlex
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