1. Eculizumab in chemotherapy-induced thrombotic microangiopathy
- Author
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Lucas Bettac, Carsten Bergmann, Joannis Mytilineos, B. Reister, Ulla Ludwig, Daniel Fürst, Lena Schulte-Kemna, Bernd Schröppel, and Rene van Erp
- Subjects
medicine.medical_specialty ,Thrombotic microangiopathy ,medicine.medical_treatment ,Renal function ,%22">Nephrology!--Bitte Füllen--> ,Case Report ,chemotherapy ,Gastroenterology ,Complement inhibitor ,aHUS ,remission ,Chemotherapy induced ,Internal medicine ,Medicine ,complement ,Chemotherapy ,business.industry ,Microangiopathic hemolytic anemia ,Eculizumab ,medicine.disease ,Discontinuation ,thrombotic microangiopathy ,eculizumab ,Geriatrics and Gerontology ,business ,medicine.drug - Abstract
Thrombotic microangiopathy (TMA) is a rare but severe complication of tumors and their chemotherapeutic treatment. We report on two patients with chemotherapy-induced TMA who were successfully treated with a short course of the terminal complement inhibitor eculizumab. Both patients quickly achieved remission of microangiopathic hemolytic anemia and recovery of renal function. After withdrawal of eculizumab, remission was stable over an observation period of 47 months and 15 months, respectively. Our data show that eculizumab is effective in treating chemotherapy-induced TMA. Discontinuation of eculizumab is feasible once the complement-activating condition is controlled and the trigger is eliminated. Additional studies need to determine the optimal duration of complement-directed therapies and validate effective monitoring strategies after discontinuation of such therapy.
- Published
- 2020