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A syndrome of microangiopathic hemolytic anemia, renal impairment, and pulmonary edema in chemotherapy‐treated patients with adenocarcinoma
Author(s) -
Sheldon Robert,
Slaughter David
Publication year - 1986
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19861001)58:7<1428::aid-cncr2820580709>3.0.co;2-j
Subject(s) - medicine , microangiopathic hemolytic anemia , chemotherapy , plasmapheresis , ards , schistocyte , gastroenterology , case fatality rate , respiratory distress , surgery , adenocarcinoma , adenocarcinoma of the lung , lung , cancer , thrombotic thrombocytopenic purpura , immunology , epidemiology , platelet , antibody
Chemotherapy is frequently used to treat adenocarcinoma. Thirty‐nine cases are reviewed in which the patients developed a hemolytic‐uremic‐like syndrome, apparently in response to chemotherapy. About 44% of the patients had gastric adenocarcinoma, and 82% had received mitomycin C. Most patients (75%) developed the syndrome 6 to 12 months after starting chemotherapy, and 60% were in remission. Severe microangiopathic hemolytic anemia, thrombocytopenia, and renal impairment were each noted in about 90% of the cases. Neurologic symptoms were usually absent, but 49% of the patients developed adult respiratory distress syndrome (ARDS). The overall case fatality rate was 72%; those patients with ARDS had a 95% mortality rate, while 50% of those without ARDS survived. The half‐life of survival of those who ultimately died was 2 months. Treatment is unsatisfactory, although steroids and plasmapheresis may prolong survival.