Collapsing Glomerulopathy Following Anthracycline Therapy

We report 2 cases of anthracycline-induced collapsing glomerulopathy, one in a patient treated for peripheral T-cell lymphoma, and the other in a kidney transplant recipient treated for acute myeloid leukemia. Collapsing glomerulopathy is a distinct variant of focal segmental glomerulosclerosis (FSGS) that has been attributed to several different causes besides human immunodeficiency virus (HIV) in recent years. Previously, anthracycline use has been associated with FSGS, not otherwise specified (NOS). However, in the absence of therapy, various hematolymphoid malignancies have been associated with FSGS, NOS and collapsing glomerulopathy. In individuals who have hematolymphoid malignancy or are being treated with an anthracycline, the frequency of FSGS is extremely low. We suggest that in the following 2 patients, anthracycline use caused collapsing FSGS based on the temporal relationship, but also in the context of potentially underlying predisposing conditions. Host and environmental factors may interact to cause one morphologic form of FSGS or another.