Thrombotic Microangiopathies Secondary to Anticancer Treatment in Patients Receiving Gemcitabine and Anti-vascular Endothelial Growth Factor: A Case Series

Abstract

Thrombotic microangiopathy (TMA) secondary to anticancer drugs exhibits varying clinicopathological presentation and severity, with variable response and prognosis upon discontinuation of the medication. We conducted a retrospective, monocentric, descriptive, and analytical study involving 7 patients with anticancer drug-induced TMA. The first group received anti-VEGF treatment, while the second group received gemcitabine. Five patients were treated with anti-VEGF (71.4%), and two patients received gemcitabine (28.6%). The mean age of patients in the anti-VEGF group was 68.8 ± 10.4 years, compared to 61.0 ± 5.6 years in the gemcitabine group. Only 28.6% had evidence of biological TMA at the time of diagnosis (n=2), exclusively in the gemcitabine group. During the acute phase, two patients required hemodialysis, both of whom were receiving gemcitabine. The mean time to death from the initial diagnosis was 6.5 ± 3.1 months. The primary cause of death was cancer progression. The overall mean survival was 25.42 ± 9.02 months, with 53 ± 3 months in the gemcitabine group and only 14.4 ± 7.99 months in the second group.