Requiring Caution in the Interpretation of Donor-Derived Cell-Free DNA Levels During Cancer Treatment in a Kidney Transplant Recipient.: A Case Report.
증례보고
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Cancer Genomics and Diagnostics
Acute Myeloid Leukemia Research
Renal Transplantation Outcomes and Treatments
[INTRODUCTION] Donor-derived cfDNA (dd-cfDNA) indicates allograft rejection when > 1% of total cfDNA, but tumor-derived cfDNA can interfere in cancer patients.
APA
Nanaka Katsurayama, Toshihito Hirai, et al. (2026). Requiring Caution in the Interpretation of Donor-Derived Cell-Free DNA Levels During Cancer Treatment in a Kidney Transplant Recipient.: A Case Report.. IJU case reports, 9, e70180. https://doi.org/10.1002/iju5.70180
MLA
Nanaka Katsurayama, et al.. "Requiring Caution in the Interpretation of Donor-Derived Cell-Free DNA Levels During Cancer Treatment in a Kidney Transplant Recipient.: A Case Report.." IJU case reports, vol. 9, 2026, pp. e70180.
PMID
42005592
Abstract
[INTRODUCTION] Donor-derived cfDNA (dd-cfDNA) indicates allograft rejection when > 1% of total cfDNA, but tumor-derived cfDNA can interfere in cancer patients.
[CASE PRESENTATION] A 61-year-old male kidney transplant recipient with metastatic renal cell carcinoma (RCC) initiated avelumab and axitinib. Following two cycles of Immno-oncology (IO) therapy, serum creatinine (Cr) levels increased to 3.1 mg/dL. Although %dd-cfDNA remained below the conventional 1% threshold, it rose to 0.41%, representing a relative change value (RCV) of +178% from baseline. Two weeks later, Cr increased to 4.5 mg/dL, accompanied by severe hyponatremia, necessitating discontinuation of IO therapy, treated with methylprednisolone and resumed IO therapy; however, Cr remained elevated; he required hemodialysis.
[CONCLUSION] RCV from baseline %dd-cfDNA may serve as a more reliable indicator of allograft injury, facilitating earlier intervention in transplant recipients undergoing IO therapy.
[CASE PRESENTATION] A 61-year-old male kidney transplant recipient with metastatic renal cell carcinoma (RCC) initiated avelumab and axitinib. Following two cycles of Immno-oncology (IO) therapy, serum creatinine (Cr) levels increased to 3.1 mg/dL. Although %dd-cfDNA remained below the conventional 1% threshold, it rose to 0.41%, representing a relative change value (RCV) of +178% from baseline. Two weeks later, Cr increased to 4.5 mg/dL, accompanied by severe hyponatremia, necessitating discontinuation of IO therapy, treated with methylprednisolone and resumed IO therapy; however, Cr remained elevated; he required hemodialysis.
[CONCLUSION] RCV from baseline %dd-cfDNA may serve as a more reliable indicator of allograft injury, facilitating earlier intervention in transplant recipients undergoing IO therapy.