Gemcitabine-related thrombotic microangiopathy: a single-centre retrospective series

• Published in: Journal of chemotherapy (Florence) Vol. 26; no. 3; pp. 169 - 172
• Main Authors: Leal, Frederico, Macedo, Ligia T., Carvalheira, José Barreto C.
• Format: Journal Article
• Language: English
• Published: Firenze Taylor & Francis 01.06.2014; EIFT; Taylor & Francis Ltd
• Subjects: Adult; Anemias. Hemoglobinopathies; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antimetabolites, Antineoplastic - adverse effects; Biological and medical sciences; Chemotherapy; Deoxycytidine - adverse effects; Deoxycytidine - analogs & derivatives; Diseases of red blood cells; Drug toxicity; Gemcitabine; Hematologic and hematopoietic diseases; Humans; Incidence; Male; Medical sciences; Middle Aged; Neoplasms - drug therapy; Pharmacology. Drug treatments; Platelet diseases and coagulopathies; Retrospective Studies; Thrombotic microangiopathies; Thrombotic Microangiopathies - chemically induced; Thrombotic Microangiopathies - epidemiology; Thrombotic thrombocytopenic purpura; Antineoplastic agent; Skin disease; Gemcitabine; Toxicity; Cardiovascular disease; Hemopathy; Thrombohemolytic microangiopathy; Vascular disease; Thrombotic thrombocytopenic purpura; Hemolytic anemia; Drug toxicity; Pyrimidine nucleoside; Drug; Nervous system diseases; Urinary system disease; Vascular disorders of the skin; Retrospective; Chemotherapy; Platelet; Treatment; Antimetabolic; Thrombotic microangiopathies; Pyrimidine derivatives; Capillary vessel disease; Fluorine Organic compounds; Coagulopathy
• ISSN: 1120-009X; 1973-9478
• DOI: 10.1179/1973947813Y.0000000122

Introduction: Thrombotic microangiopathy (TMA) has been reported as a complication of chemotherapy. Many antineoplastic agents have been linked to TMA, gemcitabine being one of the most frequently cited as related to this syndrome. Methods: A retrospective search for chemotherapy-induced TMA cases among gemcitabine users in a single oncology centre from January 2009 to September 2012 was performed. Results: Three cases of gemcitabine-induced TMA were reported, from a total of 264 patients (incidence: 1·13%) who received the drug. From the three cases reported, two (66%) patients died as a consequence of the syndrome. Discussion: These findings are compatible with previous analyses, which report an incidence of gemcitabine-associated TMA ranging from 0·008 to 2·2% and mortality rates from 15 to 90%. Unlike previously reported, however, cumulative dose was not predictive of risk. Conclusion: Gemcitabine-induced TMA is an underdiagnosed condition characterized by high mortality rates. Attention should be called for a higher level of awareness to provide early diagnosis and proper treatment.