nefrНефрологияNephrology (Saint-Petersburg)1561-62742541-9439Pavlov First Saint-Petersburg State Medical University10.36485/1561-6274-2020-24-6-19-27nefr-1898Research ArticleОРИГИНАЛЬНЫЕ СТАТЬИ. КЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯORIGINAL ARTICLES. CLINICAL INVESTIGATIONSКлинико-морфологическая характеристика и отдаленный прогноз при моноклональной гаммапатии ренального значения: опыт одного центраClinical and morphological spectrum and long-term outcome in monoclonal gammopathy of renal significance: one center studyhttps://orcid.org/0000-0001-7863-9080СмирновА. В.SmirnovA. V.

Проф. Смирнов Алексей Владимирович, д-р мед. наук, научно-исследовательский институт нефрологии, директор

197022, Санкт-Петербург, ул. Л. Толстого, д. 17, корп. 54Тел.: +7(921)949-59-32

Prof. Alexey V. Smirnov, MD, PhD, DMedSci, Research Institute of Nephrology, Director

197022, Saint Petersburg, L. Tolstoy st., 17, build 54Phone: +7(921)949-59-32 

smirnov@nephrolog.ruhttps://orcid.org/0000-0002-7179-5520ДобронравовВ. А.DobronravovV. A.

Проф. Добронравов Владимир Александрович, д-р мед. наук, заместитель директора по научной работе научно-исследовательского института нефрологии

197022, Санкт-Петербург, ул. Л. Толстого, д. 17, корп. 54Тел.: +7(812)338-69-01 

Prof. Vladimir A. Dobronravov, MD, PhD, DSc, Research Institute of Nephrology, Deputy Director for Research

197022, Saint Petersburg, L. Tolstoy st., 17, build. 54Phone: +7(812)338-69-01 

dobronravov@nephrolog.ruhttps://orcid.org/0000-0002-8141-4488ХраброваМ. С.KhrabrovaM. S.

Доц. Храброва Мария Сергеевна, канд. мед. наук, кафедра пропедевтики внутренних болезней с клиникой

197022, Санкт-Петербург, ул. Л. Толстого, д. 17, корп. 54Тел.: +7(812)338-69-01

Associate professor Maria S. Khrabrova, MD, PhD, Department of Propedeutics of Internal Diseases with the Сlinic

197022, Saint Petersburg, L. Tolstoy st., 17, build. 54Phone: +7(812)338-69-01 

hrabrovamc@gmail.comПервый Санкт-Петербургский государственный медицинский университет имени академика И.П. ПавловаРоссияPavlov UniversityRussian Federation2020241120202461927Copyright © Смирнов А.В., Добронравов В.А., Храброва М.С., 20202020Смирнов А.В., Добронравов В.А., Храброва М.С.Smirnov A.V., Dobronravov V.A., Khrabrova M.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nephrolog.ru/jour/article/view/1898AL-амилоидознеамилоидные варианты моноклональной гаммапатии ренального значениямоноклональный иммуноглобулинпочечный ответгематологический ответклон-ориентированное лечениеAL-amyloidosisnon-amyloid types of monoclonal gammopathy of renal significancemonoclonal immunoglobulinrenal responsehematological responseclone-specific treatmentReferencesLeung N, Bridoux F, Hutchison CA et al. Monoclonal gammopathy of renal significance: when MGUS is no longer undetermined or insignificant. Blood 2012;120(22):4292-4295. doi: 10.1182/blood-2012-07-445304Leung N, Bridoux F, Hutchison CA et al. Monoclonal gammopathy of renal significance: when MGUS is no longer undetermined or insignificant. Blood 2012;120(22):4292-4295. doi: 10.1182/blood-2012-07-445304Смирнов АВ, Афанасьев БВ, Поддубная ИВ и др. Моноклональная гаммапатия ренального значения: консенсус гематологов и нефрологов России по введению нозологии, диагностике и обоснованности клон-ориентированной терапии. Нефрология 2019; 23(6): 9-28. doi: 10.36485/1561-62742019-236-9-28Smirnov AV, Afanasyev BV, Poddubnaya IV et al. Monoclonal gammopathy of renal significance: Consensus of hematologists and nephrologists of Russia on the establishment of nosology, diagnostic approach and rationale for clone specific treatment. Nephrology (Saint-Petersburg) 2019;23(6):9-28. (In Russ.) doi: 10.36485/1561-6274-2019-236-9-28Fermand JP, Bridoux F, Dispenzieri A et al. Monoclonal gammopathy of clinical significance: a novel concept with therapeutic implications. Blood 2018;132(14):1478-1485. doi: 10.1182/blood-2018-04-839480Fermand JP, Bridoux F, Dispenzieri A et al. Monoclonal gammopathy of clinical significance: a novel concept with therapeutic implications. Blood 2018;132(14):1478-1485. doi: 10.1182/blood-2018-04-839480Sethi S, Rajkumar SV. Monoclonal gammopathy-associated proliferative glomerulonephritis. Mayo Clin Proc 2013;88(11):12841293. doi: 10.1016/j.mayocp.2013.08.002Sethi S, Rajkumar SV. Monoclonal gammopathy-associated proliferative glomerulonephritis. Mayo Clin Proc 2013;88(11):12841293. doi: 10.1016/j.mayocp.2013.08.002Jain A, Haynes R, Kothari J et al. Pathophysiology and management of monoclonal gammopathy of renal significance. Blood Adv 2019; 3(15): 2409-2423. doi: 10.1182/bloodadvances.2019031914Jain A, Haynes R, Kothari J et al. Pathophysiology and management of monoclonal gammopathy of renal significance. Blood Adv 2019; 3(15): 2409-2423. doi: 10.1182/bloodadvances.2019031914Zuo C, Zhu Y, Xu G. An update to the pathogenesis for monoclonal gammopathy of renal significance. Crit Rev Oncol Hematol 2020;149: 102926. doi: 10.1016/j.critrevonc.2020.102926Zuo C, Zhu Y, Xu G. An update to the pathogenesis for monoclonal gammopathy of renal significance. Crit Rev Oncol Hematol 2020;149: 102926. doi: 10.1016/j.critrevonc.2020.102926Khera A, Panitsas F, Djebbari F et al. Long term outcomes in monoclonal gammopathy of renal significance. Br J Haematol 2019;186(5):706-716. doi: 10.1111/bjh.15987Khera A, Panitsas F, Djebbari F et al. Long term outcomes in monoclonal gammopathy of renal significance. Br J Haematol 2019;186(5):706-716. doi: 10.1111/bjh.15987Steiner N, Göbel G, Suchecki P et al. Monoclonal gammopathy of renal significance (MGRS) increases the risk for progression to multiple myeloma: an observational study of 2935 MGUS patients. Oncotarget 2017;9(2):2344-2356. doi: 10.18632/oncotarget.23412Steiner N, Göbel G, Suchecki P et al. Monoclonal gammopathy of renal significance (MGRS) increases the risk for progression to multiple myeloma: an observational study of 2935 MGUS patients. Oncotarget 2017;9(2):2344-2356. doi: 10.18632/oncotarget.23412Храброва МС, Добронравов ВА, Смирнов АВ. Поражения почек, ассоциированные с моноклональными гаммапатиями: одноцентровое исследование. Нефрология 2018; 22(6): 38-46. doi: 10.24884/1561-6274-2018-22-6-38-46Khrabrova MS, Dobronravov VA, Smirnov AV. Kidney disease associated with monoclonal gammopathies: single-center study. Nephrology (Saint-Petersburg) 2018; 22(6):38-46. (In Russ.). doi: 10.24884/1561-6274-2018-22-6-38-46Leung N, Bridoux F, Batuman V et al. The evaluation of monoclonal gammopathy of renal significance: a consensus report of the International Kidney and Monoclonal Gammopathy Research Group. Nat Rev Nephrol 2019;15(1):45-59. doi: 10.1038/s41581-018-0077-4Leung N, Bridoux F, Batuman V et al. The evaluation of monoclonal gammopathy of renal significance: a consensus report of the International Kidney and Monoclonal Gammopathy Research Group. Nat Rev Nephrol 2019;15(1):45-59. doi: 10.1038/s41581-018-0077-4Levey AS, Stevens LA, Schmid CH et al. A new equation to estimate glomerular filtration rate. Ann Intern Med 2009; 150 (9): 604-612Levey AS, Stevens LA, Schmid CH et al. A new equation to estimate glomerular filtration rate. Ann Intern Med 2009; 150 (9): 604-612Сиповский ВГ, Добронравов ВА, Карунная АВ, Смирнов АВ. Клинико-морфологический анализ изменений перитубулярных микрососудов интерстиция почек у больных IgA-нефропатией (IgAN) с оценкой активности лектинового пути системы комплемента. Нефрология 2013;17(4):89-94. doi: 10.24884/1561-6274-2013-17-4-89-94Sipovskyi VG, Dobronravov VA, Karunnaya AV, Smirnov A.V. Clinical and morphological analysis of changes of peritubular microcirculation vessels of kidney interstitial tissue in patients with IgA-nephropathy (IgAN) with estimation of lectin pathway of complement activation. Nephrology (Saint-Petersburg) 2013; 17(4): 89-94. (In Russ.) doi: 10.24884/1561-6274-2013-17-4-89-94Fermand JP, Bridoux F, Kyle RA et al. How I treat monoclonal gammopathy of renal significance (MGRS). Blood 2013;122(22):3583-90. doi: 10.1182/blood-2013-05-495929Fermand JP, Bridoux F, Kyle RA et al. How I treat monoclonal gammopathy of renal significance (MGRS). Blood 2013;122(22):3583-90. doi: 10.1182/blood-2013-05-495929Palladini G, Dispenzieri A, Gertz MA et al. New criteria for response to treatment in immunoglobulin light chain amyloidosis based on freelight chain measurement and cardiac biomarkers: impact on survival outcomes. J Clin Oncol 2012;30(36):4541-9. doi: 10.1200/JCO.2011.37.7614Palladini G, Dispenzieri A, Gertz MA et al. New criteria for response to treatment in immunoglobulin light chain amyloidosis based on freelight chain measurement and cardiac biomarkers: impact on survival outcomes. J Clin Oncol 2012;30(36):4541-9. doi: 10.1200/JCO.2011.37.7614Gertz MA. Waldenström macroglobulinemia: 2018 update on diagnosis, risk stratification, and management. Am J Hematol 2018;1-11. doi: 10.1002/ajh.25292Gertz MA. Waldenström macroglobulinemia: 2018 update on diagnosis, risk stratification, and management. Am J Hematol 2018;1-11. doi: 10.1002/ajh.25292NCCN Clinical Practice Guidelines in Oncology version 4.2014. Non-Hodgkin’s lymphomas. Режим доступа (available at): https://www.nccn.org/about/nhl.pdfNCCN Clinical Practice Guidelines in Oncology version 4.2014. Non-Hodgkin’s lymphomas. Режим доступа (available at): https://www.nccn.org/about/nhl.pdfOwen RG, Kyle RA, Stone MJ et al. Response assessment in Waldenström macroglobulinaemia: update from the VIth International Workshop. Br J Haematol 2013;160 (2): 171-176. doi: 10.1111/bjh.12102Owen RG, Kyle RA, Stone MJ et al. Response assessment in Waldenström macroglobulinaemia: update from the VIth International Workshop. Br J Haematol 2013;160 (2): 171-176. doi: 10.1111/bjh.12102Palladini G, Hegenbart U, Milani P et al. A staging system for renal outcome and early markers of renal response to chemotherapy in AL amyloidosis. Blood 2014;124(15):2325-2332. doi: 10.1182/blood-2014-04-570010Palladini G, Hegenbart U, Milani P et al. A staging system for renal outcome and early markers of renal response to chemotherapy in AL amyloidosis. Blood 2014;124(15):2325-2332. doi: 10.1182/blood-2014-04-570010Fish R, Pinney J, Jain P et al. The Incidence of major hemorrhagic complications after renal biopsies in patients with monoclonal gammopathies. Clin J Am Soc Nephrol 2010; 5(11):1977-1980. doi: 10.2215/CJN.00650110Fish R, Pinney J, Jain P et al. The Incidence of major hemorrhagic complications after renal biopsies in patients with monoclonal gammopathies. Clin J Am Soc Nephrol 2010; 5(11):1977-1980. doi: 10.2215/CJN.00650110Yu XJ, Zhang X, Li DY et al. Renal pathologic spectrum and clinical outcome of monoclonal gammopathy of renal significance: A large retrospective case series study from a single institute in China. Nephrology (Carlton) 2020; 25(3):202-211. doi: 10.1111/nep.13633Yu XJ, Zhang X, Li DY et al. Renal pathologic spectrum and clinical outcome of monoclonal gammopathy of renal significance: A large retrospective case series study from a single institute in China. Nephrology (Carlton) 2020; 25(3):202-211. doi: 10.1111/nep.13633Zakharova EV, Makarova TA, Stolyarevich ES, Vorobyeva OA. Monoclonal immunoglobulin–mediated kidney disease: What is beyond amyloidosis in real practice? Journal of Onco-Nephrology 2019; 3(3):105-112. doi:10.1177/2399369319870188Zakharova EV, Makarova TA, Stolyarevich ES, Vorobyeva OA. Monoclonal immunoglobulin–mediated kidney disease: What is beyond amyloidosis in real practice? Journal of Onco-Nephrology 2019; 3(3):105-112. doi:10.1177/2399369319870188Menè P, De Alexandris L, Moioli A et al. Monoclonal Gammopathies of Renal Significance: Renal Biopsy and Beyond. Cancers (Basel) 2020;12(7):1741. doi: 10.3390/cancers12071741Menè P, De Alexandris L, Moioli A et al. Monoclonal Gammopathies of Renal Significance: Renal Biopsy and Beyond. Cancers (Basel) 2020;12(7):1741. doi: 10.3390/cancers12071741Leung N, Barnidge DR, Hutchison CA. Laboratory testing in monoclonal gammopathy of renal significance (MGRS). Clin Chem Lab Med 2016;54(6): 929-937. doi: 10.1515/cclm-2015-0994Leung N, Barnidge DR, Hutchison CA. Laboratory testing in monoclonal gammopathy of renal significance (MGRS). Clin Chem Lab Med 2016;54(6): 929-937. doi: 10.1515/cclm-2015-0994Gumber R, Cohen JB, Palmer MB et al. A clone-directed approach may improve diagnosis and treatment of proliferativeglomerulonephritis with monoclonal immunoglobulin deposits. Kidney Int 2018;94(1):199-205. doi: 10.1016/j.kint.2018.02.020Gumber R, Cohen JB, Palmer MB et al. A clone-directed approach may improve diagnosis and treatment of proliferativeglomerulonephritis with monoclonal immunoglobulin deposits. Kidney Int 2018;94(1):199-205. doi: 10.1016/j.kint.2018.02.020Yui JC, Garceau D, Jhaveri KD et al. Monoclonal gammopathy-associated thrombotic microangiopathy. Am J Hematol 2019;94(10): E250-E253. doi: 10.1002/ajh.25569Yui JC, Garceau D, Jhaveri KD et al. Monoclonal gammopathy-associated thrombotic microangiopathy. Am J Hematol 2019;94(10): E250-E253. doi: 10.1002/ajh.25569Gnemmi V, Leleu X, Provot F et al. Cast nephropathy and light-chain deposition disease in Waldenström macroglobulinemia. Am J Kidney Dis 2012;60(3):487-491. doi: 10.1053/j.ajkd.2012.01.030Gnemmi V, Leleu X, Provot F et al. Cast nephropathy and light-chain deposition disease in Waldenström macroglobulinemia. Am J Kidney Dis 2012;60(3):487-491. doi: 10.1053/j.ajkd.2012.01.030Kanjanabuch T, Bunruang R, Srisawat N et al. The combination of thrombotic microangiopathy and nodular sclerosis in light chain deposition disease. J Med Assoc Thai 2006; 89 Suppl 2:S248-52Kanjanabuch T, Bunruang R, Srisawat N et al. The combination of thrombotic microangiopathy and nodular sclerosis in light chain deposition disease. J Med Assoc Thai 2006; 89 Suppl 2:S248-52Vos JM, Gustine J, Rennke HG et al. Renal disease related to Waldenström macroglobulinaemia: incidence, pathology and clinical outcomes. Br J Haematol 2016;175(4):623-630. doi: 10.1111/bjh.14279Vos JM, Gustine J, Rennke HG et al. Renal disease related to Waldenström macroglobulinaemia: incidence, pathology and clinical outcomes. Br J Haematol 2016;175(4):623-630. doi: 10.1111/bjh.14279Chauvet S, Bridoux F, Ecotière L et al. Kidney diseases associated with monoclonal immunoglobulin M-secreting B-cell lymphoproliferative disorders: a case series of 35 patients. Am J Kidney Dis 2015;66(5):756-767. doi: 10.1053/j.ajkd.2015.03.035Chauvet S, Bridoux F, Ecotière L et al. Kidney diseases associated with monoclonal immunoglobulin M-secreting B-cell lymphoproliferative disorders: a case series of 35 patients. Am J Kidney Dis 2015;66(5):756-767. doi: 10.1053/j.ajkd.2015.03.035Lee B, Smith RS, Tanphaichitr N et al. Waldenström's macroglobulinemia and nephrotic syndrome with membranous nephropathy. Scand J Urol Nephrol 2011; 45(6): 473-477. doi: 10.3109/00365599.2011.568954Lee B, Smith RS, Tanphaichitr N et al. Waldenström's macroglobulinemia and nephrotic syndrome with membranous nephropathy. Scand J Urol Nephrol 2011; 45(6): 473-477. doi: 10.3109/00365599.2011.568954Zand L, Nasr SH, Gertz MA et al. Clinical and prognostic differences among patients with light chain deposition disease, myeloma cast nephropathy and both. Leuk Lymphoma 2015;56(12):3357-3364. doi: 10.3109/10428194.2015Zand L, Nasr SH, Gertz MA et al. Clinical and prognostic differences among patients with light chain deposition disease, myeloma cast nephropathy and both. Leuk Lymphoma 2015;56(12):3357-3364. doi: 10.3109/10428194.2015Lin J, Markowitz GS, Valeri AM et al. Renal monoclonal immunoglobulin deposition disease: the disease spectrum. J Am Soc Nephrol 2001; 12(7):1482-1492Lin J, Markowitz GS, Valeri AM et al. Renal monoclonal immunoglobulin deposition disease: the disease spectrum. J Am Soc Nephrol 2001; 12(7):1482-1492Nasr SH, Valeri AM, Cornell LD et al. Renal monoclonal immunoglobulin deposition disease: A report of 64 patients from a single institution. Clin J Am Soc Nephrol 2012; 7:231-239Nasr SH, Valeri AM, Cornell LD et al. Renal monoclonal immunoglobulin deposition disease: A report of 64 patients from a single institution. Clin J Am Soc Nephrol 2012; 7:231-239Kourelis TV, Nasr SH, Dispenzieri A et al. Outcomes of patients with renal monoclonal immunoglobulin deposition disease. Am J Hematol 2016;91(11):1123-1128. doi: 10.1002/ajh.24528Kourelis TV, Nasr SH, Dispenzieri A et al. Outcomes of patients with renal monoclonal immunoglobulin deposition disease. Am J Hematol 2016;91(11):1123-1128. doi: 10.1002/ajh.24528Cohen C, Royer B, Javaugue V et al. Bortezomib produces high hematological response rates with prolonged renal survival in monoclonal immunoglobulin deposition disease. Kidney Int 2015;88:1135-1143Cohen C, Royer B, Javaugue V et al. Bortezomib produces high hematological response rates with prolonged renal survival in monoclonal immunoglobulin deposition disease. Kidney Int 2015;88:1135-1143Ziogas DC, Kastritis E, Terpos E et al. Hematologic and renal improvement of monoclonal immunoglobulin deposition disease after treatment with bortezomib-based regimens. Leuk Lymphoma 2017;58(8):1832-1839. doi: 10.1080/10428194.2016.1267349Ziogas DC, Kastritis E, Terpos E et al. Hematologic and renal improvement of monoclonal immunoglobulin deposition disease after treatment with bortezomib-based regimens. Leuk Lymphoma 2017;58(8):1832-1839. doi: 10.1080/10428194.2016.1267349Kastritis E, Gavriatopoulou M, Roussou M et al. Renal outcomes in patients with AL amyloidosis: Prognostic factors, renal response and the impact of therapy. Am J Hematol 2017;92(7):632-639. doi: 10.1002/ajh.24738Kastritis E, Gavriatopoulou M, Roussou M et al. Renal outcomes in patients with AL amyloidosis: Prognostic factors, renal response and the impact of therapy. Am J Hematol 2017;92(7):632-639. doi: 10.1002/ajh.24738Zhu Z, Yue C, Sun Y, Li X, Li M. Light-chain amyloidosis with renal involvement: renal outcomes and validation of two renal staging systems in the Chinese population. Amyloid 2019;26(4):186-191. doi: 10.1080/13506129.2019.1639149Zhu Z, Yue C, Sun Y, Li X, Li M. Light-chain amyloidosis with renal involvement: renal outcomes and validation of two renal staging systems in the Chinese population. Amyloid 2019;26(4):186-191. doi: 10.1080/13506129.2019.1639149Amaador K, Peeters H, Minnema MC et al. Monoclonal gammopathy of renal significance (MGRS) histopathologic classification, diagnostic workup, and therapeutic options. Neth J Med 2019;77(7): 243-254Amaador K, Peeters H, Minnema MC et al. Monoclonal gammopathy of renal significance (MGRS) histopathologic classification, diagnostic workup, and therapeutic options. Neth J Med 2019;77(7): 243-254Palladini G, Kastritis E, Maurer MS et al. Daratumumab plus CyBorD for patients with newly diagnosed AL amyloidosis: safety run-in results of ANDROMEDA. Blood 2020;136(1):71-80. doi: 10.1182/blood.2019004460Palladini G, Kastritis E, Maurer MS et al. Daratumumab plus CyBorD for patients with newly diagnosed AL amyloidosis: safety run-in results of ANDROMEDA. Blood 2020;136(1):71-80. doi: 10.1182/blood.2019004460Milani P, Basset M, Curci P et al. Daratumumab in light chain deposition disease: rapid and profound hematologic response preserves kidney function. Blood Adv 2020;4(7):13211324. doi: 10.1182/bloodadvances.2020001553Milani P, Basset M, Curci P et al. Daratumumab in light chain deposition disease: rapid and profound hematologic response preserves kidney function. Blood Adv 2020;4(7):13211324. doi: 10.1182/bloodadvances.2020001553Kastritis E, Theodorakakou F, Roussou M et al. Daratumumab-based therapy for patients with monoclonal gammopathy of renal significance. Br J Haematol 2020 doi: 10.1111/bjh.17052Kastritis E, Theodorakakou F, Roussou M et al. Daratumumab-based therapy for patients with monoclonal gammopathy of renal significance. Br J Haematol 2020 doi: 10.1111/bjh.17052

The authors declare that there are no conflicts of interest present.