Microangiopathic Hemolytic Anemia in Metastatic Carcinoma

Lohrmann, Hans‐Peter

doi:10.7326/0003-4819-79-3-368

Cited by 152 publications

(42 citation statements)

References 22 publications

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“…1 patient was in need of dialysis due to progressive renal failure, whereas the 2nd patient showed symptoms of HUS (microangiopathic changes in blood smear, thrombocytopenia, and elevation of creatinine < 3.0 × ULN) but without clinical consequences. Microangio- [25][26][27][28]. It could be shown that cumulative doses of MMC up to 200 mg can be given without any occurrence of HUS events [18].…”

Section: Discussionmentioning

confidence: 99%

High-Dose 5-Fluorouracil / Folinic Acid in Combination with Three-Weekly Mitomycin C in the Treatment of Advanced Gastric Cancer. A Phase II Study

Hofheinz¹,

Hartung²,

Samel

et al. 2002

Oncol Res Treat

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Background: The 24-hour continuous infusion of 5-fluorouracil (5-FU) and folinic acid (FA) as part of several new multidrug chemotherapy regimens in advanced gastric cancer (AGC) has shown to be effective, with low toxicity. In a previous phase II study with 3-weekly bolus 5-FU, FA and mitomycin C (MMC) we found a low toxicity rate and response rates comparable to those of regimens such as ELF, FAM or FAMTX, and a promising median overall survival. In order to improve this MMC-dependent schedule we initiated a phase II study with high-dose 5-FU/FA and 3-weekly bolus MMC. Patients and Methods: From February, 1998 to September, 2000 we recruited 33 patients with AGC to receive weekly 24-hour 5-FU 2,600 mg/m² preceded by 2-hour FA 500 mg/m² for 6 weeks, followed by a 2-week rest period. Bolus MMC 10 mg/m² was added in 3-weekly intervals. Treatment given on an outpatient basis, using portable pump systems, was repeated on day 57. Patients’ characteristics were: male/female ratio 20/13; median age 57 (27–75) years; median WHO status 1 (0–2). 18 patients had a primary AGC, and 15 showed a relapsed AGC. Median follow-up was 11.8 months (range of those surviving: 2.7–11.8 months). Results: 32 patients were evaluable for response – complete remission 9.1% (n = 3), partial remission 45.5% (n = 15), no change 27.3% (n = 9), progressive disease 15.1% (n = 5). Median overall survival time was 10.2 months [95% confidence interval (CI): 8.7–11.6], and median progression-free survival time was 7.6 months (95% CI: 4.4–10.9). The worst toxicities (%) observed were (CTC-NCI 1/2/3): leukopenia 45.5/18.2/6.1, thrombocytopenia 33.3/9.1/6.1, vomitus 24.2/9.1/0, diarrhea 36.4/6.1/3.0, stomatitis 18.2/9.1/0, hand-foot syndrome 12.1/0/0. Two patients developed hemolytic-uremic syndrome (HUS). Conclusions: High-dose 5-FU/FA/MMC is an effective and well-tolerated outpatient regimen for AGC (objective response rate 54.6%). It may serve as an alternative to cisplatin-containing regimens; however, it has to be considered that possibly HUS may occur.

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Section: Discussionmentioning

confidence: 99%

High-Dose 5-Fluorouracil / Folinic Acid in Combination with Three-Weekly Mitomycin C in the Treatment of Advanced Gastric Cancer. A Phase II Study

Hofheinz¹,

Hartung²,

Samel

et al. 2002

Oncol Res Treat

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“…In cancer patients microangiopathic hemolytic anemia (MAHA) is usually seen in advanced disease [1,2]. Hemolytic uremic syndrome (HUS) is a special form of MAHA with predominantly renal involvement.…”

Section: Introductionmentioning

confidence: 99%

Hemolytic Uremic Syndrome in Prostatic Carcinoma

Müller

Paulweber²

1998

Oncology

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Background: Disseminated intravascular coagulation is a well-known complication of adenocarcinoma of the prostate, while hemolytic uremic syndrome (HUS) is not. Case Report: We describe the unusual case of a 61-year-old patient with adenocarcinoma of the prostate. Prior to any systemic therapy he developed hemolytic uremic syndrome (HUS) necessitating dialysis. Renal function has fully recovered and he is alive and well 7 years later. Conclusion: HUS is a rare complication of adenocarcinoma of the prostate and has a far better prognosis than chemotherapy-associated HUS.

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“…In a review article of HUS, Gold stein et al [12] mentioned such an association referring to the study of Lohrman et al [13] in which metastatic carcinoma was associated with MAHA but not HUS. Among previous observations of HUS in association with malignancy we found only 3 reports where the syn drome occurred in the absence of chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Recurrent Hemolytic Uremic Syndrome and Metastatic Malignancy

Sennesael¹,

Houte²,

Spapen³

et al. 1987

Am J Nephrol

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A 64-year-old patient with a prostatic adenocarcinoma presented two well-documented episodes of hemolytic-uremic syndrome (HUS) occurring 8 months apart and resolving without renal sequelae. The temporal relationship between these episodes and the natural progression of the underlying disease as well as the absence of chemotherapy favor the hypothesis of cancer-associated HUS. The clinical, laboratory and pathological findings of this patient and 3 additional patients reported in the literature are discussed. These cases suggest that malignancy should be suspected in adults developing the HUS and that this form of HUS need not have a poor prognosis despite progressive cancer.

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Microangiopathic Hemolytic Anemia in Metastatic Carcinoma

Abstract: Fig 3.-Section of thymoma removed at surgery (hematoxylineosin, x40

Cited by 152 publications

References 22 publications

High-Dose 5-Fluorouracil / Folinic Acid in Combination with Three-Weekly Mitomycin C in the Treatment of Advanced Gastric Cancer. A Phase II Study

High-Dose 5-Fluorouracil / Folinic Acid in Combination with Three-Weekly Mitomycin C in the Treatment of Advanced Gastric Cancer. A Phase II Study

Hemolytic Uremic Syndrome in Prostatic Carcinoma

Recurrent Hemolytic Uremic Syndrome and Metastatic Malignancy

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