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Related Experiment Videos

Nephrotoxicity from cancer immunotherapy.

G M Dosik, J U Gutterman, E M Hersh

    Annals of Internal Medicine
    |July 1, 1978
    PubMed
    Summary
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    Systemic Corynebacterium parvum immunotherapy can cause kidney damage in melanoma patients. Cessation of treatment led to spontaneous recovery of renal function in all affected individuals.

    Area of Science:

    • Immunology
    • Nephrology
    • Oncology

    Background:

    • Systemic intravenous immunotherapy with Corynebacterium parvum (C. parvum) is recognized for its immunopotentiating and immunotherapeutic effects in animal models.
    • Clinical investigations have been initiated to evaluate its efficacy and safety in humans, with noted toxicities often managed symptomatically.

    Observation:

    • Three patients undergoing C. parvum immunotherapy for metastatic melanoma presented with a distinct clinical syndrome.
    • This syndrome included oliguria, edema, pulmonary infiltrates, azotemia, hypoalbuminemia, and hypocomplementemia.

    Findings:

    • Renal biopsies revealed proliferative glomerulonephritis with subendothelial deposits.
    • Immunofluorescence demonstrated glomerular deposition of IgG, IgA, IgM, and C3 complement.

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  • A retrospective review identified a fourth patient with similar renal complications, establishing a frequency of 3/87 in C. parvum treatment protocols.

    • Implications:

    • C. parvum immunotherapy can induce significant renal toxicity, specifically glomerulonephritis, in patients with metastatic melanoma.
    • Renal function improved spontaneously in all affected patients upon discontinuation of C. parvum therapy.
    • Continuous monitoring of renal function is crucial for patients receiving systemic adjuvant immunotherapy, particularly with agents like C. parvum.