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incidence of gemcitabine induced HUS in our population of pancreatic cancer patients receiving adjuvant treatment and to ascertain potential risk factors. Methods: We reviewed 187 patients on adjuvant gemcitabine for pancreatic carcinoma. We collected data about haemoglobin, platelets, white cells count, creatinine clearance before each cycle. We calculated the maximum drop between baseline and minimum level of haemoglobin and creatinine clearance for all these patients. Results: We found that two patients developed HUS (1.06%). 185 patients developed a maximum drop in haemoglobin of 22% (18-27%) and around 19% in creatinine clearance (10-45%). The HUS patients had a drop in haemoglobin of 37% and 34% and a drop in creatinine clearance of 41% and 31%. We carried out a logistic regression analysis. This showed that a drop in haemoglobin >25% and in creatinine clearance >30% from baseline, increased significantly the chances of developing HUS (p 0.0001). Conclusion: Our data point to a significant drop in hemoglobin and creatinine clearance as two significant risk factors to develop HUS induced by gemcitabine. We recommended that in cases with high index of suspicion, gemcitabine should be stopped or delayed until we receive the results of extra tests such as haptoglobin, lactate dehydrogenase, test de Coombs, to confirm or rule out this diagnosis.

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