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Updated: Aug 13, 2026
Immunoglobulin Gene Sequence Analysis In Chronic Lymphocytic Leukemia: From Patient Material To Sequence Interpretation
Published on: November 26, 2018
Chronic lymphocytic leukemia-associated membranous glomerulopathy: remission with fludarabine
Insights
Chronic lymphocytic leukemia (CLL) can cause membranous nephropathy and nephrotic syndrome. Treatment of CLL with fludarabine led to remission of nephrotic syndrome in a patient with this rare association.
Area of Science:
- Nephrology
- Hematology
- Oncology
Background:
- Chronic lymphocytic leukemia (CLL) is a hematologic malignancy characterized by abnormal lymphocyte proliferation.
- CLL can be associated with glomerular diseases, including membranous nephropathy, leading to nephrotic syndrome.
- The link between CLL and nephrotic syndrome is supported by cases where proteinuria remits with reduced lymphocyte counts after chemotherapy.
Observation:
- This report details a patient with CLL and co-occurring membranous glomerulopathy.
- The patient presented with nephrotic syndrome secondary to the glomerulopathy.
- This represents a rare clinical presentation of CLL-associated kidney disease.
Findings:
- The patient received fludarabine, a purine analogue used for refractory CLL.
- Following fludarabine treatment, the patient experienced remission of nephrotic syndrome.
- This is the first reported case of CLL-associated membranous glomerulopathy and nephrotic syndrome remitting after fludarabine therapy.
Implications:
- Fludarabine may be an effective treatment for nephrotic syndrome in patients with CLL and membranous glomerulopathy.
- This finding highlights the potential for treating the underlying malignancy to resolve associated kidney complications.
- Further research is warranted to explore the efficacy and mechanisms of fludarabine in CLL-related nephrotic syndrome.
Abstract:
In some individuals, chronic lymphocytic leukemia (CLL) may be associated with glomerular disease from membranous nephropathy with resultant nephrotic syndrome. CLL is characterized by abnormal immunoregulation with a malignant clonal proliferation of lymphocytes. The association between the abnormal clone and nephrotic syndrome is suggested in some cases by the remission of proteinuria with a reduction in abnormal lymphocyte number after treatment with antineoplastic agents. For the first time, we describe a patient with CLL and associated membranous glomerulopathy whose nephrotic syndrome remitted after treatment with fludarabine, a new purine analogue used in the treatment of refractory CLL.
