Chronic lymphocytic leukaemia presenting as renal failure with lymphocytic infiltration of the kidneys

A case of renal failure is reported in a 60-yr-old male as the first clinical manifestation of chronic lymphocytic leukaemia (CLL). It appeared to be due to a massive interstitial infiltration of both kidneys by small lymphocytes. Combination chemotherapy consisting of monthly courses of cyclophosphamide, vincristine and prednisone (COP), resulted in a rapid improvement of the renal function and in an apparent haematological and clinical remission of the CLL. After six courses, the COP therapy was stopped and replaced by a maintenance treatment with oral chlorambucil. During follow up, now lasting more than 3 years, no deterioration of renal function has been noted.