Thrombotic microangiopathy: a new dose-limiting toxicity of high-dose sequential chemotherapy

Bone Marrow Transplantation
J M VantelonV Ribrag

Abstract

Ten patients with refractory (n = 8) or early relapsing (n = 2) aggressive non-Hodgkin's lymphoma were enrolled in a pilot study evaluating a high-dose sequential chemotherapy regimen with peripheral blood stem cell (PBSC) support. Five treatment phases were scheduled: phase I (cyclophosphamide + etoposide followed by lenograstim (G-CSF), and a PBSC harvest); phase II (cisplatinum + cytarabine + etoposide followed by lenograstim); phases III and IV (cyclophosphamide + cytarabine + etoposide followed by autologous PBSC infusion and lenograstim); and phase V (carmustine + cytarabine + etoposide + melphalan followed by autologous PBSC infusion and lenograstim). Ten, nine, eight, six and four of the 10 patients received one, two, three, four and five of the five scheduled phases of treatment, respectively. Four patients were withdrawn from the study due to progressive disease and two due to thrombotic microangiopathy (TM). Moreover, in the four patients who completed all treatment phases, an additional case of TM was seen. In all three patients with TM, laboratory studies showed evidence of Coombs negative hemolytic anemia, thrombocytopenia, renal dysfunction and in addition cardiac failure in two patients. TM may be a new dose-lim...Continue Reading

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Citations

Feb 22, 2002·Current Opinion in Nephrology and Hypertension·Ravinder K Wali, William L Henrich
Jan 8, 2013·American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation·Neeraj SinghGanesh Shidham
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Feb 9, 2016·Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners·Gwenalyn Garcia, Jean Paul Atallah

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