Palbociclib-Induced Thrombotic Microangiopathy in Metastatic Breast Cancer Patient Surviving for 18 Years: Case Report and Review of the Literature

Raiss, Hanan; Péron, Julien; Tartas, Sophie; Trillet‐Lenoir, Véronique; Errihani, Hassan

doi:10.1016/j.clbc.2017.10.001

Cited by 8 publications

(6 citation statements)

References 16 publications

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“…This bedside diagnostic tool has high sensitivity to predict ADAMTS-13 deficiency, however, is only recommended for use in patients with thrombocytopenia (platelets less than 150×10 9 /L) and schistocytes on peripheral smear (suggesting MAHA) 8. In this case, the patient’s low PLASMIC score4 was consistent with 0% chance of ADAMTS-13 deficiency, effectively ruling out TTP 8. Systemic cancer can mimic TTP; thus a bone marrow evaluation in patients with a history of cancer should be pursued when there are inconsistencies in the clinical features of primary TMA 9 10…”

Section: Differential Diagnosismentioning

confidence: 54%

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Dedifferentiated liposarcoma with heterologous rhabdomyosarcomatous differentiation in the bone marrow

Scott,

Hakima,

Raff

2023

BMJ Case Rep

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We present a case of advanced well-differentiated liposarcoma transforming to dedifferentiated liposarcoma in the bone marrow.Our patient presented with 5 weeks of worsening flank pain. He was found to have profound leukocytosis, thrombocytopenia, and normocytic anemia. Imaging showed a dominant retrocaval mass concerning for viable disease. Bone marrow biopsy revealed dedifferentiated liposarcoma with heterologous rhabdomyosarcomatous differentiation. He underwent 3 cycles of eribulin and subsequently developed complications of his increasingly aggressive liposarcoma. He was transitioned to hospice care and died 3 months after initial bone marrow biopsy. While exceedingly rare, it is possible for liposarcoma to metastasize to the bone marrow and cause rapid progression to death. In patients with high-grade liposarcoma, new cytopenia, leukocytosis, elevated granulocyte colony stimulating factor, and/or leukoerythroblasosis on peripheral smear should prompt bone marrow biopsy for early detection of this rare disease entity.

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Section: Differential Diagnosismentioning

confidence: 54%

“…Further historical review demonstrated anemia for the preceding 7 years with only a gradual decrease in hemoglobin over the past 4 months. Palbociclib was held, given the association with thrombocytopenia 4…”

Section: Investigationsmentioning

confidence: 99%

Dedifferentiated liposarcoma with heterologous rhabdomyosarcomatous differentiation in the bone marrow

Scott,

Hakima,

Raff

2023

BMJ Case Rep

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“…One case of palbociclib-induced TMA has been previously described [5]; however, in our case, TMA had occurred well before palbociclib therapy was implemented. In addition, an association between palbociclib and letrozole enabled the patient to become stabilized.…”

Section: Discussionmentioning

confidence: 68%

Atypical Evolution of Secondary Hemolytic Uremic Syndrome Defined as Paraneoplastic Syndrome under Eculizumab and Palbociclib Therapies

Perrier¹,

Noble²,

Grangé³

et al. 2021

Case Rep Oncol

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Thrombotic microangiopathy (TMA) is most of the time caused by thrombotic thrombocytopenic purpura or hemolytic uremic syndrome. A 60-year-old female was diagnosed in 2014 with mammary breast adenocarcinoma treated by several-line therapy: mastectomy, docetaxel, cyclophosphamide, radiotherapy, doxorubicine, and capecitabine. By mid-November, the patient was admitted to the hospital with regenerative, mechanical, and hemolytic anemia, schistocytes at 3%, and thrombopenia (99 G/L), associated with high blood transfusion requirement. After 9 sessions of plasmapheresis, there was no significant improvement in the biological parameters, nor after 2 cycles of paclitaxel. The patient was then treated with eculizumab during 4 weeks, with a slight reduction in blood requirement, and simultaneously with palbociclib. Since being treated with palpociclib, she had a great reduction in blood requirement and a good clinical condition. To conclude, we reported an initial moderate improvement of paraneoplasm-related TMA syndrome under eculizumab therapy with a slight reduction in red blood cell requirement; however, palbociclib therapy achieved a very good response with a dramatic reduction in red blood cell requirement.

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“…Palbociclib inhibits the cyclin-dependent kinases CDK4 and CDK6. Cases reporting a link between the aforementioned TKIs and druginduced TMA have been described in literature (6,(53)(54)(55)(56).…”

Section: Vegf Kinase and Immune Checkpoint Inhibitorsmentioning

confidence: 99%

An Update in Drug-Induced Thrombotic Microangiopathy

et al. 2020

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Palbociclib-Induced Thrombotic Microangiopathy in Metastatic Breast Cancer Patient Surviving for 18 Years: Case Report and Review of the Literature

Cited by 8 publications

References 16 publications

Dedifferentiated liposarcoma with heterologous rhabdomyosarcomatous differentiation in the bone marrow

Dedifferentiated liposarcoma with heterologous rhabdomyosarcomatous differentiation in the bone marrow

Atypical Evolution of Secondary Hemolytic Uremic Syndrome Defined as Paraneoplastic Syndrome under Eculizumab and Palbociclib Therapies

An Update in Drug-Induced Thrombotic Microangiopathy

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