Asian Journal of Research in Nephrology

Thrombotic Microangiopathies Secondary to Anticancer Treatment in Patients Receiving Gemcitabine and Anti-vascular Endothelial Growth Factor: A Case Series

S. Hamine *

Department of Nephrology, Hemodialysis and Renal Transplantation, University Hospital Henri Mondor, Paris, France.

Z. Shao-Yu

Department of Nephrology, Hemodialysis and Renal Transplantation, University Hospital Henri Mondor, Paris, France.

D. Sahali

Department of Nephrology, Hemodialysis and Renal Transplantation, University Hospital Henri Mondor, Paris, France.

P. Grimbert

Department of Nephrology, Hemodialysis and Renal Transplantation, University Hospital Henri Mondor, Paris, France.

*Author to whom correspondence should be addressed.

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Abstract

Thrombotic microangiopathy (TMA) secondary to anticancer drugs exhibits varying clinicopathological presentation and severity, with variable response and prognosis upon discontinuation of the medication. We conducted a retrospective, monocentric, descriptive, and analytical study involving 7 patients with anticancer drug-induced TMA. The first group received anti-VEGF treatment, while the second group received gemcitabine. Five patients were treated with anti-VEGF (71.4%), and two patients received gemcitabine (28.6%). The mean age of patients in the anti-VEGF group was 68.8 ± 10.4 years, compared to 61.0 ± 5.6 years in the gemcitabine group. Only 28.6% had evidence of biological TMA at the time of diagnosis (n=2), exclusively in the gemcitabine group. During the acute phase, two patients required hemodialysis, both of whom were receiving gemcitabine. The mean time to death from the initial diagnosis was 6.5 ± 3.1 months. The primary cause of death was cancer progression. The overall mean survival was 25.42 ± 9.02 months, with 53 ± 3 months in the gemcitabine group and only 14.4 ± 7.99 months in the second group.

Keywords: Thrombotic microangiopathy, anti-vascular endothelial growth factor, gemcitabine

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Clin Nephrol. 2021;96(1):51-59.

DOI: 10.5414/CN110443

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