Acute Kidney Injury Requiring Dialysis following Carmustine and Etoposide during Autologous Stem Cell Transplantation

The Stanford BCNU protocol (carmustine, etoposide and cyclophosphamide) is a high-dose conditioning regimen widely used prior to autologous stem cell transplantation. While acute renal failure requiring renal replacement therapy is a known but rare complication of autologous stem cell transplantation, acute nephrotoxicity following carmustine and etoposide has not yet been reported.We present the first case of carmustine-induced acute kidney injury in the setting of autologous stem cell transplantation and perform a review of the literature. Renal failure was associated with a sharp rise in serum creatinine, oliguria and trace proteinuria. Urgent haemodialysis was required; however, renal failure resolved after 7 days.Although a rare complication, its severity mandates close monitoring of renal function as early recognition and treatment may limit long-term sequelae.