Thrombotic Microangiopathy Syndromes

Zakarija, Anaadriana

doi:10.1007/978-0-387-79962-9_8

Cited by 5 publications

(3 citation statements)

References 90 publications

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“…While acute DIC is uncommon presentation for most hematologic malignancies, urokinase-like plasminogen activator has been found in blasts of acute promyelocytic leukemia (APL) which often lead to DIC prior to widespread treatment with alltrans retinoic acid [17,18]. Chemotherapy agents such as cisplatin, bleomycin, daunorubicin, and calcineurin inhibitors used in HSCT patients such as cyclosporine and tacrolimus have been shown to independently lead to drug-induced MAHA [19].…”

Section: Pathophysiology Of Anemia In Patients With Malignant Hematolmentioning

confidence: 99%

Transfusions for anemia in adult and pediatric patients with malignancies

2015

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Anemia is present in over two-thirds of patients with malignant hematological disorders. The etiology of anemia predominates from ineffective erythropoiesis from marrow infiltration, cytokine related suppression, erythropoietin suppression, and vitamin deficiency; ineffective erythropoiesis is further exacerbated by accelerated clearance due to antibody mediated hemolysis and thrombotic microangiopathy. As the anemia is chronic in nature, symptoms are generally well tolerated and often non-specific. Transfusion of red blood cells (RBCs) is a balance between providing benefit for patients while avoiding risks of transfusion. Conservative/restrictive RBC transfusion practices have shown equivalent patient outcomes compared to liberal transfusion practices, and meta-analysis has shown improved in-hospital mortality, reduced cardiac events, re-bleeding, and bacterial infections. The implications for a lower threshold for transfusion in patients with malignancies are therefore increasingly being scrutinized. Alternative management strategies for anemia with IV iron and erythropoietin stimulating agents (ESAs) should be considered in the appropriate settings.

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Section: Pathophysiology Of Anemia In Patients With Malignant Hematolmentioning

confidence: 99%

Transfusions for anemia in adult and pediatric patients with malignancies

2015

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“…A generalized microthrombi formation is, however, mostly seen in metastatic cancer, with findings similar to those seen in thrombotic microangiopathy (TMA), also known as microangiopathic hemolytic anemia. [67][68][69][70] The features of cancer-associated TMA are distinct from those of acute idiopathic thrombotic thrombocytopenic purpura (TTP) and of hemolytic-uremic syndrome (HUS), in that there is no preferential localization of the microthrombotic lesions in the brain and kidneys. [70][71][72] In contrast to TTP, there is systemic coagulopathy and the microthrombi are rich in fibrin.…”

Section: Tumor Microvasculaturementioning

confidence: 99%

Microvascular Thrombosis: A Serious and Deadly Pathologic Process in Multiple Diseases

Kwaan

2011

Semin Thromb Hemost

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Much of our understanding of the pathogenesis of thrombosis has long been based on observations made on large blood vessels. Nevertheless, there has been a recent shift in our attention to the microvasculature and to how microcirculatory occlusion affects function of various organs in diseases. This article provides an overview of microthrombosis in small blood vessels, with discussion of the progressive stages of its development. The initial event is triggered by a variety of diseases, followed by a second phase when multiple contributory factors amplify the process with the final phase of microvascular occlusion and microvascular thrombosis. The outcome is either recovery or injury to the affected organ. If the process is generalized, it is often associated with catastrophic or fatal outcomes. Our current knowledge of the major role of contributory factors leads to a new paradigm. A therapeutic approach limited to a single target of the underlying pathogenic factor, such as the use of anticoagulants, is insufficient and too often unsuccessful. Simultaneous management of all the contributory factors should therefore be considered.

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“…Thrombotic microangiopathy (TMA) is a clinical association of thrombocytopenia, microangiopathic haemolytic anaemia and organ dysfunction related to microvascular thrombosis [1, 2]. TMA is associated with significant mortality and morbidity including acute renal failure [3], a common feature caused by high susceptibility of renal vessels to endothelial damage [3].…”

Section: Introductionmentioning

confidence: 99%

Cabazitaxel Induced Thrombotic Microangiopathy in a Patient with Prostate Cancer

Nlandu

Pourcine

Vong

et al. 2019

Case Reports in Nephrology

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Cancer-associated thrombotic microangiopathy (TMA) refers to a group of disorders characterized by microangiopathic haemolytic anemia, thrombocytopenia, and ischemic organ damage. TMA manifestations can be induced by cancer or by chemotherapy. We report the case of a 64-year-old man with metastatic prostate cancer who experienced a Cabazitaxel-induced TMA manifestation. TMA responds to conservative therapy, dialysis without plasmaphoresis, with progressive recovered renal function.

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Thrombotic Microangiopathy Syndromes

Cited by 5 publications

References 90 publications

Transfusions for anemia in adult and pediatric patients with malignancies

Transfusions for anemia in adult and pediatric patients with malignancies

Microvascular Thrombosis: A Serious and Deadly Pathologic Process in Multiple Diseases

Cabazitaxel Induced Thrombotic Microangiopathy in a Patient with Prostate Cancer

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