Treatment of cancer chemotherapy-associated thrombotic thrombocytopenic purpura/hemolytic uremic syndrome by protein A immunoadsorption of plasma
CancerPublished 1 March 1993Open access
Harry W. Snyder, A Mittelman, Ayhan Oral, Gerald L. Messerschmidt, David H. Henry, S Korec
Citations107
SJR quartileQ1
SJR score2.95
SNIP1.90
Generate an AI Snapshot to get a quick, structured summary of this paper.
Study Snapshot
ObjectiveStudy objective
MethodsResearch methodology
PopulationPopulation studied
Sample sizeSample sizes
OutcomesStudy outcomes here
ResultsStudy results comes here
LimitationsResearch study limitations comes here
A concise AI-generated summary of the paper will appear here once you click Generate AI Snapshot.
TL;DR
C‐TTP/HUS is a condition involving thrombocytopenia, microangiopathic hemolytic anemia, and progressive renal dysfunction that develops in 2–10% of patients with a history of malignant neoplasms treated with certain chemotherapeutic agents.
Abstract
This multicenter study establishes protein A immunoadsorption as an effective and safe treatment for cancer chemotherapy-associated TTP/HUS, an otherwise fatal disease.
Keywords
Immunology and MicrobiologyMedicine
Journal of Clinical OncologyCancer-associated hemolytic-uremic syndrome: analysis of 85 cases from a national registry.
287 Citations1989J B Lesesne, Nicole D. Rothschild +8 more
Recommendations include careful monitoring of renal and hematologic function in patients treated with MMC, aggressive nontransfusion in patients with suspected C-HUS, and consideration of treatment with SPA immunopheresis in Patients with definite syndrome.
Annals of Internal MedicineThrombotic Microangiopathy and Renal Failure Associated with Antineoplastic Chemotherapy
185 Citations1984Alan M. Jackson, BURTON D. ROSE +8 more
Five patients with carcinoma developed thrombotic microangiopathy after treatment with cisplatin, bleomycin, and a vinca alkaloid, and each was tumor-free or had only a small tumor at the onset of this syndrome, which may have been induced by chemotherapy.
Journal of Clinical OncologyCarcinoma-associated hemolytic-uremic syndrome: a complication of mitomycin C chemotherapy.
156 Citations1985J E Cantrell, Terry M. Phillips +1 more
A thrombotic microangiopathy resembling the hemolytic uremic syndrome was diagnosed in 12 patients with adenocarcinoma, in whom the tumor was in complete or near-complete remission after treatment with mitomycin C-containing drug regimens.
CancerRenal disease after mitomycin c therapy
116 Citations1981Wahid T. Hanna, Stephen Krauss +2 more
Fourteen patients with adenocarcinoma of the gastrointestinal tract and pancreas treated with mitomycin C(MMC) and 5‐fluorouracil (5‐FU) had renal impairment 6‐11 months from the beginning of MMC therapy.
CancerA syndrome of microangiopathic hemolytic anemia, renal impairment, and pulmonary edema in chemotherapy-treated patients with adenocarcinoma
113 Citations1986Robert S. Sheldon, David Slaughter
Thirty‐nine cases are reviewed in which the patients developed a hemolytic‐uremic‐like syndrome, apparently in response to chemotherapy, and those patients with ARDS had a 95% mortality rate, while 50% of those without ARDS survived.
CancerMicroangiopathic hemolytic anemia, thrombocytopenia, and renal failure in patients treated for adenocarcinoma
89 Citations1981Bruce Kressel, Kevin P. Ryan +3 more
The syndrome was clinically identical whether or not grossly metastatic tumor was present, and it should not be attributed to advanced disease without definite clinical or pathologic evidence of a recurrence.
Journal of Clinical OncologyTreatment of cancer-associated hemolytic uremic syndrome with staphylococcal protein A immunoperfusion.
75 Citations1986S Korec, Philip S. Schein +5 more
Plasma perfusion over filters containing staphylococcal protein A was used to treat 11 patients with adenocarcinoma who developed a hemolytic uremic syndrome and appears to be an effective form of therapy for this otherwise fatal syndrome.
CancerMicroangiopathic hemolytic anemia observed after treatment of epidermoid carcinoma with mitomycin C and 5-fluorouracil
74 Citations1980Subhash C. Gulati, Peter P. Sordillo +5 more
This is the first report of epidermoid carcinoma manifesting MAHA changes after chemotherapy, and speculation as to pathogenesis and appropriate therapy are discussed.
The LancetINTRAVASCULAR HÆMOLYSIS AND RENAL IMPAIRMENT AFTER BLOOD TRANSFUSION IN TWO PATIENTS ON LONG-TERM 5-FLUOROURACIL AND MITOMYCIN-C
67 Citations1980B Jones, C.E. Newman +3 more
In a multicentre trial of adjuvant chemotherapy in gastric adenocarcinoma, a number of patients developed chronic haemolysis and renal failure following long-term treatment with 5-fluorouracil and mitomycin-C.
Journal of Clinical OncologyProtein A immunoadsorption in the treatment of malignant disease.
51 Citations1988Gerald L. Messerschmidt, David H. Henry +8 more
Protein A immunoadsorption of plasma is well tolerated in the outpatient clinic, has demonstrated antitumor activity in resistant solid tumors, and functions as a biologic response modifier.
Archives of Internal MedicineMitomycin-induced hemolytic-uremic syndrome. Successful treatment with corticosteroids and intense plasma exchange
49 Citations1983Neil Lyman
Archives of Internal MedicineMitomycin-Associated Renal Failure
48 Citations1983Ronald W. Hamner
A 45-year-old man in whom renal failure and anemia developed, without evidence of hemolysis, five months after beginning chemotherapy with mitomycin, fluorouracil, and doxorubicin hydrochloride is described.
PubMedMitomycin-induced hemolytic-uremic syndrome.
48 Citations1984Alan D. Proia, E A Harden +1 more
From a review of the literature and initial results of a randomized chemotherapy protocol for metastatic adenocarcinoma of the colorectum, it appears that mitomycin was the most likely cause for the development of the HUS in these patients.
BMJGastric carcinoma and thrombotic thrombocytopenic purpura: association with plasma immune complex concentrations.
47 Citations1982Stephen Zimmerman, Frederick P. Smith +3 more
It is postulated that reducing the tumour and the pre-existing state of antigen excess by chemotherapy allowed soluble antigen-antibody complexes to form and the syndrome to develop.
PubMedModulation of immunity in patients with autoimmune disease and cancer treated by extracorporeal immunoadsorption with PROSORBA columns.
45 Citations1989Snyder Hw, Balint Jp +1 more
Extra-corporeal immunoadsorption of plasma over columns containing a silica matrix and covalently attached highly purified staphylococcal protein A (PROSORBA column) is a procedure that specifically removes plasma components by the interaction of protein A with the Fc region of IgG.
CancerCisplatin-associated hemolytic-uremic syndrome. Successful treatment with a staphylococcal protein A column
42 Citations1989Peter R. Watson, Troy H. Guthrie +1 more
The cases of two patients with squamous cell carcinoma of the head and neck who developed massive hemolysis, profound thrombocytopenia, and dialysis‐dependent renal failure after therapy with cisplatin are reported to support the role of staphylococcal protein A plasma perfusion as treatment for this condition.
PubMedMicroangiopathic hemolytic anemia, renal failure, and noncardiogenic pulmonary edema: a chemotherapy-induced syndrome.
42 Citations1983Jacques Jolivet, L Giroux +4 more
Chemotherapy-induced microangiopathic hemolytic anemia and renal failure may predispose patients to fatal episodes of noncardiogenic pulmonary edema that can be triggered by blood transfusions.
Human PathologyChronic glomerular microangiopathy and metastatic carcinoma
36 Citations1979Dennis L. Laffay, Raymond R. Tubbs +3 more
Two patients with metastatic colonic adenocarcinoma developed deterioration of renal function six and nine months after the diagnosis of malignant disease and postmortem specimens revealed thickening of glomerular capillary loops with focal reduplication of basement membrane-like material.
Journal of Clinical PathologyHaemolytic-uraemic syndrome complicating long-term mitomycin C and 5-fluorouracil therapy for gastric carcinoma.
34 Citations1983J. Crocker, E. L. Jones
Three cases of acute renal toxicity in patients receiving long-term therapy with mitomycin C and 5-fluorouracil are reported, with the appearances of the renal lesions being similar to those seen in the haemolytic-uraemic syndrome.
CancerRenal failure and hemolytic anemia associated with mitomycin C. A case report
32 Citations1985Todd M. Price, Anthony J. Murgo +3 more
Examination of the renal biopsy specimen revealed glomerular sclerosis and necrosis with interstitial fibrosis on light microscopy, and electron microscopic findings revealed deposits of fibrin within the glomeruli and interstitial tissue and separation ofglomerular epithelial cells from the underlying lamina densa.
CancerRecovery from mitomycin C-induced hemolytic uremic syndrome: A case report
28 Citations1984J. Verwey, Epie Boven +2 more
Artificial OrgansReduction in Platelet‐Binding Immunoglobulins and Improvement in Platelet Counts in Patients with HIV‐Associated Idiopathic Thrombocytopenia Purpura (ITP) Following Extracorporeal Immunoadsorption of Plasma Over Staphylococcal Protein A‐Silica
27 Citations1989Harry W. Snyder, Juergen H. Bertram +4 more
Removal of platelet-directed antibodies and circulating immune complexes from plasma by extracorporeal immunoadsorption of IgG and CIC from plasma is a beneficial new treatment modality for HIV-associated ITP.
Artificial OrgansProtein A Immunoadsorption Therapy in HIV‐Related Immune Thrombocytopenia: A Preliminary Report
26 Citations1988Juergen H. Bertram, Harry W. Snyder +5 more
Activated complement components and removal of CIC and IgG thus may contribute to the platelet-enhancing activity of SpA immunoadsorption therapy.
American Journal of Kidney DiseasesPlasmapheresis and Antiplatelet Agents in the Treatment of the Hemolytic Uremic Syndrome Secondary to Mitomycin
25 Citations1986Signy Chow, Julia Roscoe +1 more
Four patients with the hemolytic uremic syndrome secondary to mitomycin therapy were treated with intense plasmapheresis and antiplatelet agents and results suggest an important role for these agents inMitomycin-induced Hemolytic Uremic Syndrome.
European Journal of Cancer and Clinical OncologyMicroangiopathic hemolytic anemia, a frequent complication of mitomycin therapy in cancer patients
22 Citations1984U. Bruntsch, G. Groos +2 more
It is concluded that MAHA is a frequent and potentially fatal complication of long-term mitomycin treatment and careful monitoring for the early appearance of schistocytes is mandatory as the syndrome tends to be self-limited if this therapy is discontinued early.
Journal of Cancer Research and Clinical OncologyHemolytic uremic syndrome in a patient on cis-platinum, vinblastine and bleomycin
20 Citations1985J van der Meer, Elisabeth G.E. de Vries +4 more
Infusion of fresh frozen plasma together with aspirin and dipyridamole resulted in recovery of microangiopathic hemolytic anemia and thrombocytopenia, however, Renal insufficiency persisted.
PubMedPulmonary angiomatoid vascular changes in mitomycin C-associated hemolytic-uremic syndrome.
20 Citations1985V. Y. H. Chang-Poon, W. S. Hwang +4 more
Angiomatoid vascular changes in lungs and pulmonary hemorrhage are described in a woman in whom mitomycin C-associated hemolytic-uremiclike syndrome developed.
American Journal of Clinical OncologyRenal toxicity of mitomycin-C
16 Citations1984Thanjavur S. Ravikumar, Richard Sibley +2 more
The renal morphologic changes reveal a glomerular and vascular process similar to that seen in a number of clinical situations associated with the hematologic findings of microangiopathic hemolytic anemia.
The Pathophysiology of Circulating Immune Complexes: Their Role in Host-Tumor Interactions and Removal by Immunoadsorption Therapy
14 Citations1985Terence M. Phillips, Thomas V. Holohan +3 more
Circulating immune complexes, which in reality are aggregates of floating immunological debris, having the potential not only to cause damage to a number of different organs but also to play a role in immune regulation, are studied.
PubMedTreatment of mitomycin-associated microangiopathic hemolytic anemia with vincristine.
14 Citations1986Jean L. Grem, James A. Merritt +1 more
CancerComplete necrotization of hepatocellular carcinoma by chemotherapy and subsequent intravascular coagulation.A case report
8 Citations1978Toshinori Harada, Y. Makisaka +2 more
A 45‐year‐old man with hepatocellular carcinoma who developed intravascular coagulation following complete tumor regression by chemotherapy is described, and generalized fibrin thrombi were seen in the afferent arterioles of glomeruli as accounted for by intrav vascular coagulated.
Archives of Internal MedicineTreatment of Mitomycin-Associated Microangiopathic Hemolytic Anemia With Vincristine
6 Citations1986Jean L. Grem
Two patients who had MAHA and renal dysfunction during chemotherapy that included mitomycin were treated; theMAHA and hypertension both objectively improved after treatment that included vincristine sulfate.
Cancer InvestigationHemolytic Anemia Thrombocytopenia and Renal Failure in a Patient Apparently Cured of Anal Carcinoma
3 Citations1985Andrew G. Huvos, Lee S. Schwartzberg
A poorly differentiated epidermoid carcinoma of the anal canal invading the colon wall at the squamo-columnar junction was found and an abdominal-perineal resection and colostomy were performed without complications.