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Author Spotlight: Advancing Cancer Associated Thrombosis Research in Rodent Models
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[Breast cancer-related thrombotic microangiopathy: A review]

Marion Alhenc-Gelas1, François-Clément Bidard1

  • 1Institut Curie, département d'oncologie médicale, 35, rue Dailly, 92210 Saint-Cloud, France.

Bulletin Du Cancer
|May 30, 2021
PubMed

Insights

Cancer-related microangiopathic hemolytic anemia (MAHA) in breast cancer is rare and aggressive. Standard treatments are ineffective, with urgent anti-cancer therapy offering the best prognosis for this severe condition.

Area of Science:

  • Hematology
  • Oncology
  • Pathology

Background:

  • Thrombotic microangiopathies (TM) are characterized by hemolytic anemia and thrombocytopenia.
  • Cancer-related TM, or microangiopathic hemolytic anemia (MAHA), can arise from various cancers, particularly mucin-producing adenocarcinomas.
  • Breast cancer-associated MAHA (BC-MAHA) is a specific subtype with poorly understood incidence and characteristics.

Purpose of the Study:

  • To review and analyze published cases of TM in breast cancer patients.
  • To specifically investigate the clinical features, incidence, and outcomes of BC-MAHA.
  • To evaluate the efficacy of current treatments for BC-MAHA.

Main Methods:

  • Conducted a Medline search to identify original published cases of TM in breast cancer.
  • Included cases of BC-MAHA and drug-related MAHA for comparison.
  • Analyzed patient demographics, clinical presentation, laboratory findings, and treatment outcomes.

Main Results:

  • Identified 158 MAHA cases: 118 BC-MAHA and 40 drug-related MAHA.
  • BC-MAHA predominantly occurs in disseminated breast cancer with bone or medullary involvement.
  • Patients present with poor general condition, bone pain, dyspnea, and frequent coagulation disorders.
  • Standard MAHA treatments (plasmapheresis, immunoglobulins) were ineffective for BC-MAHA.

Conclusions:

  • BC-MAHA is a rare, aggressive complication of advanced breast cancer.
  • Prognosis for BC-MAHA is extremely poor.
  • Urgent anti-neoplastic therapy, alongside supportive care, is the most promising treatment approach.
Keywords:
Breast cancerCancer du seinMicroangiopathic haemolytic anaemiaMicroangiopathie ThrombotiquePrognosisPronosticSyndrome ParanéoplasiqueThrombotic microangiopathyTraitementTreatment

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