Clinical efficacy of eculizumab as treatment of gemcitabine-induced thrombotic microangiopathy: A case report

La Revue de médecine interne
T RogierP Sève

Abstract

Gemcitabine-induced thrombotic microangiopathy is a rare event whose management is not yet consensual. The use of eculizumab could be of interest. A 68-year-old woman was treated by gemcitabine as adjuvant chemotherapy of a pancreatic adenocarcinoma. Two months later, the patient presented with mechanical hemolytic anemia, thrombocytopenia and high blood pressure that led to the diagnosis of thrombotic microangiopathy. Gemcitabine was stopped. Plasma exchange therapy was introduced since hematological and renal parameters had worsened. As clinical efficacy was insufficient, eculizumab was introduced at a dose of 900 mg per week 4 times, then 1200 mg every 2 weeks. Symptoms along with hematological and nephrological analysis were back to physiological standards after 7 intravenous injections. Eculizumab seems to be an effective treatment against gemcitabine-induced thrombotic microangiopathy in case of severe hematological and renal injuries associated with a lack of response to plasma exchange therapy.

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Citations

Dec 19, 2017·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Vinod KrishnappaRupesh Raina
Nov 6, 2018·British Journal of Clinical Pharmacology·Florence DavietNoémie Jourde-Chiche
Jan 14, 2018·BMC Nephrology·Vinod KrishnappaRupesh Raina
Oct 27, 2020·KI Reports·Lilian Monteiro P PalmaSanjeev Sethi

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