Bosutinib and Membranous Nephropathy in Chronic Myeloid Leukemia: Coincidence or Drug-Related İnjury? Bosutınıb y Nefropatía Membranosa en Leucemıa Mıeloıde Crónıca: ¿Coıncıdencıa o Lesıón Relacionada con el Fármaco?
Revista de Nefrologia, Dialisis y Trasplante, cilt.46, sa.2, ss.99-105, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 46 Sayı: 2
- Basım Tarihi: 2026
- Dergi Adı: Revista de Nefrologia, Dialisis y Trasplante
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Fuente Academica Plus, EMBASE, Directory of Open Access Journals, DIALNET, Academic Search Ultimate (EBSCO)
- Sayfa Sayıları: ss.99-105
- Anahtar Kelimeler: Bosutinib, Chronic myeloid leukemia, Membranous nephropathy, Nephrotoxicity, Tyrosine kinase inhibitors
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Tyrosine kinase inhibitors (TKIs) have significantly improved outcomes in chronic myeloid leukemia (CML), but renal adverse effects are increasingly recognized. We report a 32-year-old male with CML who developed nephrotic-range proteinuria two years after starting bosutinib. Laboratory tests showed elevated serum creatinine, hypoalbuminemia, and severe proteinuria. Renal biopsy revealed membranous nephropathy with coarse granular PLA2R and IgG4 positivity, accompanied by interstitial inflammation consistent with acute tubulointerstitial nephritis. Bosutinib was temporarily discontinued and then resumed under close multidisciplinary supervision, combined with rituximab and tacrolimus. At six months, renal function and proteinuria had significantly improved. This case questions the impact of bosutinib on glomerular and tubular damage in the kidney. Early recognition, renal biopsy, and individualized multidisciplinary management are crucial. In selected cases, continuing TKI with adjunct immunomodulatory therapy may be a feasible strategy.