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Related Experiment Videos

Gemcitabine-associated thrombotic microangiopathy.

Benjamin D Humphreys1, Jeff P Sharman, Joel M Henderson

  • 1Renal Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA.

Cancer
|June 16, 2004
PubMed
Summary

Gemcitabine-associated thrombotic microangiopathy (TMA) is more common than previously thought, occurring in 0.31% of patients. New or worsening hypertension may signal early TMA development.

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Area of Science:

  • Oncology
  • Nephrology
  • Hematology

Background:

  • Gemcitabine-associated thrombotic microangiopathy (TMA) is considered rare, with an estimated incidence of 0.015%.
  • Expanding indications for gemcitabine necessitate a comprehensive understanding of its complications.

Purpose of the Study:

  • To characterize gemcitabine-associated TMA.
  • To determine the incidence of gemcitabine-associated TMA.

Main Methods:

  • Retrospective chart review of gemcitabine-associated TMA cases at Partners Healthcare System (January 1997-February 2002).
  • Diagnosis confirmed by clinical, laboratory, and renal biopsy findings.

Main Results:

  • Nine patients with gemcitabine-associated TMA identified; cumulative incidence was 0.31%.

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  • Median age 53 years; median time to TMA development was 8 months.
  • Hypertension was a prominent feature in 7/9 patients, preceding diagnosis by 0.5-10 weeks.
  • Treatments included gemcitabine discontinuation, antihypertensives, plasma exchange, and dialysis.
  • Six patients survived; three died of disease progression. Two developed kidney failure.

    • Conclusions:

    • The incidence of gemcitabine-associated TMA in this study (0.31%) was higher than previously reported.
    • New or exacerbated hypertension may serve as an early indicator for gemcitabine-associated TMA.