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<p>Mantle cell lymphoma (MCL) is a rare subtype of B-cell non-Hodgkin lymphoma, and acute kidney injury (AKI) from direct renal infiltration is a rare but serious complication. The management of AKI secondary to renal infiltration is challenging in patients with relapsed/refractory (R/R) disease resistant to systemic chemotherapy. Herein, we report the case of a 74-year-old male with R/R MCL that was refractory to multiple lines of chemotherapy and Bruton’s tyrosine kinase inhibitors. He developed AKI from bilateral lymphomatous renal infiltration and received palliative total kidney irradiation (15&#xa0;Gy in five fractions). Since his renal function continued to worsen after initiating radiotherapy, hemodialysis was initiated. Following irradiation, his renal function rapidly improved, allowing discontinuation of hemodialysis. He was subsequently transitioned to best supportive care at home, with preserved renal function until death. This case highlights that palliative total kidney irradiation is an effective and feasible treatment option for restoring renal function in patients with AKI caused by chemorefractory MCL renal infiltration.</p>

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Palliative total kidney irradiation for acute kidney injury caused by bilateral renal infiltration of chemotherapy-resistant mantle cell lymphoma: a case report

  • 期刊论文

  • 发表日期：

    2026年3月27日

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  • Yuki Mochizuki,
  • Hiroyuki Inoo,
  • Tomoaki Yano,
  • Takamasa Mitsuyoshi,
  • Itaru Ikeda,
  • Akihiro Yoshimoto,
  • Tadakazu Kondo,
  • Masaki Kokubo

摘要

Mantle cell lymphoma (MCL) is a rare subtype of B-cell non-Hodgkin lymphoma, and acute kidney injury (AKI) from direct renal infiltration is a rare but serious complication. The management of AKI secondary to renal infiltration is challenging in patients with relapsed/refractory (R/R) disease resistant to systemic chemotherapy. Herein, we report the case of a 74-year-old male with R/R MCL that was refractory to multiple lines of chemotherapy and Bruton’s tyrosine kinase inhibitors. He developed AKI from bilateral lymphomatous renal infiltration and received palliative total kidney irradiation (15 Gy in five fractions). Since his renal function continued to worsen after initiating radiotherapy, hemodialysis was initiated. Following irradiation, his renal function rapidly improved, allowing discontinuation of hemodialysis. He was subsequently transitioned to best supportive care at home, with preserved renal function until death. This case highlights that palliative total kidney irradiation is an effective and feasible treatment option for restoring renal function in patients with AKI caused by chemorefractory MCL renal infiltration.