Abstract
We experienced two cases of acute leukemia with chronic interstitial nephritis. During maintenance chemotherapy with such anti-cancer agents as daunorubicine, vincristine, cytarabine, cyclophosphamide and neocarziostatine, renal functional impairment insidiously developed, finally leading to uremia which necessitated blood dialysis. One patient died of pneumonia and alimentary tract bleeding, while another is still alive in a good condition. Their renal tissues demonstated tubular atrophy, interstitial fibrosis and infiltration by chronic inflammatory cells. Immunofluorescence studies on sections failed to show localization of immunoglobulins, C3 or fibrin. Lung fibrosis was also considered on the basis of roentgenological findings and pulmonary function (%DLCO 14%) in one patient. Hypercalcemia and uricemia were not observed. We speculate that a direct nephrotoxic effect of the anti-cancer agents is the most likely cause of the chronic interstitial nephritis.
