The role of chemotherapy in gastric cancer-related microangiopathic haemolytic anaemia

Tang, Mónica; Goldstein, David

doi:10.21037/jgo.2016.11.14

Cited by 4 publications

(4 citation statements)

References 18 publications

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“…The existence of a proven hypercoagulability state (extensive DVT) and a possible trigger (surgical procedure, anaesthetic drugs), or some other factor not yet identified could have rapidly accelerated clinical deterioration. Regardless of the cause, cancer-associated MAHA has been shown to have a poor response to PEX; however, chemotherapy has been shown to be helpful in the short term [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Microangiopathic Haemolytic Anaemia in a Young Male Patient With Oesophageal Carcinoma

Ndlovu¹,

Czako²

2021

Cureus

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Microangiopathic haemolytic anaemia (MAHA) in patients with various solid cancers and haematological malignancies has been reported, but to our knowledge, there has been no clearly reported case of MAHA in a young patient with oesophageal adenocarcinoma. MAHA is a subgroup of haemolytic anaemias characterised by destruction of red blood cells as they traverse small-calibre blood vessels. Its most defining features are anaemia and presence of fragmented red blood cells in the circulation. MAHA associated with cancer is now a well-recognized paraneoplastic syndrome, seen in various solid tumours and haematological malignancies, the most common being gastric, breast and lung carcinoma. The development of MAHA associated with any malignant process is usually an ominous condition, not only because of the fact that no convincing treatment has been discovered to date, but also because it invariably almost always occurs in disseminated cancers as a late presentation.The prompt identification of the signs and symptoms suggestive of intravascular haemolysis, the deliberation of the cause of such symptoms and the concurrent ruling out of related conditions which may mimic MAHA symptoms such as haemolytic uremic syndrome and thrombotic thrombocytopenic purpura are crucial to ensure successful treatment. The patient is a 33-year-old male patient of Asian descent who had oesophageal adenocarcinoma that had metastasized to the peritoneal cavity and paraaortic lymph nodes. The patient was admitted with bilateral extensive deep vein thrombosis, and was later found to have pulmonary embolism as well. A few days after his admission, he suddenly developed shortness of breath, severe chest pain and was diagnosed with cancer-associated MAHA. His sudden, rapid clinical deterioration, and the inability to intervene successfully was a traumatizing experience for his doctors and relatives alike.

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Section: Discussionmentioning

confidence: 99%

Microangiopathic Haemolytic Anaemia in a Young Male Patient With Oesophageal Carcinoma

Ndlovu¹,

Czako²

2021

Cureus

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“…Only effective therapy is chemotherapy, patients who respond to therapy show resolution of hematological changes and hemolysis, reduced lymph node size and shrinking of bone lesions. Response rates are poor and as 90% of patients with MAHA have distant metastatic disease at presentation overall survival is exceptionally low [16].…”

Section: Discussionmentioning

confidence: 99%

Cancer Associated Microangiopathic Hemolytic Anemia: A Rare Paraneoplastic Syndrome

Kuchkuntla¹

2021

J Oncol Res Rev Rep

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Microangiopathic hemolytic anemias (MAHA) are secondary to damage of RBCs because of endothelial vascular damage of blood vessels leading to hemolysis. MAHAs are characterized by negative coombs test and are associated with several etiologies that include can be either hereditary complement or ADAMTS13 deficiency or sepsis or malignancy. Cancer associated MAHA (CA-MAHA) is a rare and is seen in patients with advanced metastatic disease. CA-MAHA has significant mortality rate and chemotherapy is the only therapeutic option, however overall survival is poor. Here we, present a rare case of CA-MAHA secondary to metastatic signet ring cell carcinoma with an unknown primary. In patients, when the cause of progressive MAHA is unknown, the possibility of cancer associated MAHA must be considered and a comprehensive work up for an underlying malignancy must be done.

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“…TO THE EDITOR: Microangiopathic hemolytic anemia (MAHA) refers to mechanical hemolytic anemia characterized by red blood cell fragmentation or schistocytes on peripheral blood (PB) smear [ 1 ]. MAHA is observed in various conditions such as thrombotic thrombocytopenic purpura (TTP), hemolytic uremic syndrome (HUS), disseminated intravascular coagulation (DIC), systemic infection, and immune disorders [ 2 3 4 ]. MAHA can also occur rarely in malignant tumors as paraneoplastic syndrome.…”

mentioning

confidence: 99%

“…Chemotherapy is the only effective treatment for CRMAHA. Although the prognosis of CR-MAHA is generally poor, several studies reported cases of favorable response of CR-MAHA to chemotherapy [ 2 4 5 ]. As MAHA is not a common presenting sign of cancer recurrence, early recognition of this rare presentation and prompt investigation including BM study are essential for timely management.…”

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confidence: 99%

Microangiopathic hemolytic anemia as initial presentation of recurrent colon cancer

Park

2018

Blood Res

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The role of chemotherapy in gastric cancer-related microangiopathic haemolytic anaemia

Cited by 4 publications

References 18 publications

Microangiopathic Haemolytic Anaemia in a Young Male Patient With Oesophageal Carcinoma

Microangiopathic Haemolytic Anaemia in a Young Male Patient With Oesophageal Carcinoma

Cancer Associated Microangiopathic Hemolytic Anemia: A Rare Paraneoplastic Syndrome

Microangiopathic hemolytic anemia as initial presentation of recurrent colon cancer

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