Management of cancer-associated thrombotic microangiopathy: What is the right approach?

✍ Scribed by Theresa L. Werner; Neeraj Agarwal; Heather M. Carney; George M. Rodgers

• Publisher: John Wiley and Sons
• Year: 2007
• Tongue: English
• Weight: 193 KB
• Volume: 82
• Category: Article
• ISSN: 0361-8609
• DOI: 10.1002/ajh.20783

✦ Synopsis

Abstract

A 49‐year‐old Caucasian woman presented with features suggestive of thrombotic microangiopathy (TMA). She did not respond to treatment with repeated plasma exchange and corticosteroids. A bone marrow biopsy revealed presence of metastatic carcinoma. A limited autopsy revealed presence of breast cancer with rib metastases. Though severe deficiency of von Willebrand factor‐cleaving protease was initially proposed as a key pathogenetic factor for thrombotic thrombocytopenic purpura, subsequent studies involving patients with cancer‐associated TMA did not find as severe a deficiency of von Willebrand factor‐cleaving protease as is seen in idiopathic cases of thrombotic thrombocytopenic purpura. Here we address one approach of management of these patients with cancer‐associated TMA. Am. J. Hematol., 2006. © 2006 Wiley‐Liss, Inc.