Patients with Active Mantle Cell Lymphoma May Present with Monoclonal, Polyclonal, or C3-Dominant Glomerulonephritides, Which Respond to Lymphoma-Directed Therapy
Bibliographic record
Abstract
Background: There are limited reports on kidney biopsy findings in patients with mantle cell lymphoma (MCL). Methods: We initiated a multi-institutional, retrospective review of kidney biopsy findings from patients with active and treated MCL. Results: Twenty-nine patients (31 biopsies) with MCL and kidney biopsies were identified, with a median age of 66 (range 48-87), 76% of whom were men. Nineteen patients had active MCL at the time of biopsy, 13 of which (68%) presented with acute kidney injury, proteinuria and/or hematuria, and biopsy findings attributable to lymphoma (Table); 6 (32%) had findings not readily attributable to MCL. Of the former, 10 (77%) had immune complex (IC) disease including proliferative glomerulonephritis with monotypic Ig deposits (PGNMID, 2), C3 dominant GN (3), PLA2R-negative membranous (MN, 3), and/or tubular basement membrane deposits (2). Lymphomatous infiltration was present in 6, 3 with coincident IC lesions. Four with available follow-up were treated for MCL, all with remission of GN (1 PGNMID, 2 C3 dominant GN, 1 MN). Ten patients were biopsied while MCL was in remission; these findings were attributed to various underlying diseases. Conclusions: In patients with active MCL who undergo kidney biopsy, 68% had kidney biopsy findings attributable to lymphoma. Diverse immune complex diseases were seen in ˜50%, including monoclonal, polyclonal, and C3 dominant GN patterns, and nearly 1/3rd had lymphomatous infiltration. Limited follow-up suggests these IC lesions respond to MCL-directed therapy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.003 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".