Treatment of Chemotherapy-Induced Thrombotic Microangiopathy with Eculizumab in a Patient with Metastatic Breast Cancer

Case Reports in Oncology
Martin HausbergStefan Pfeffer

Abstract

The unexpected occurrence of thrombotic microangiopathy (TMA), characterised by microangiopathic haemolytic anaemia and thrombocytopenia, in a patient with cancer requires urgent diagnosis and appropriate management. TMA in patients with metastatic cancer can be a manifestation of the malignancy itself or a therapeutic complication. Distinguishing the cause of TMA is complicated but clinically important to initiate appropriate treatment of metastatic cancer and avoid potential drug toxicity. Eculizumab, which inhibits alternative complement pathway activation, has been shown to be effective in chemotherapy-induced TMA. We report the case of a 69-year-old woman with breast cancer who experienced a mitomycin-C-induced TMA manifestation. TMA did not respond to conservative therapy, plasmapheresis or rituximab and rapidly lead to dialysis dependency. Despite disease progression and metastases, eculizumab treatment was associated with recovered renal function and enabled the patient to avoid dialysis, improving her quality of life.

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Citations

Aug 8, 2020·Journal of Investigative Medicine High Impact Case Reports·Jihad Ben GabrAndras Perl
Jun 13, 2020·Frontiers in Medicine·Thomas ChatzikonstantinouEleni Gavriilaki
Nov 28, 2020·Pediatric Nephrology : Journal of the International Pediatric Nephrology Association·Arwa Nada, Jennifer G Jetton
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Dec 1, 2020·World Journal of Gastrointestinal Oncology·Anne Katrin BergerGeorg Martin Haag
Apr 17, 2021·Translational Oncology·Patrícia ValérioJosé Maximino Costa
May 31, 2021·Bulletin du cancer·Marion Alhenc-Gelas, François-Clément Bidard

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Methods Mentioned

BETA
oncotherapy

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