Eculizumab in chemotherapy-induced thrombotic microangiopathy.

Authors :: Schulte-Kemna L
Reister B
Bettac L
Ludwig U
Fürst D
Mytilineos J
Bergmann C
van Erp R
Schröppel B
Source :: Clinical nephrology. Case studies [Clin Nephrol Case Stud] 2020 Apr 17; Vol. 8, pp. 25-32. Date of Electronic Publication: 2020 Apr 17 (Print Publication: 2020).
Publication Year :: 2020
Abstract: Thrombotic microangiopathy (TMA) is a rare but severe complication of tumors and their chemotherapeutic treatment. We report on two patients with chemotherapy-induced TMA who were successfully treated with a short course of the terminal complement inhibitor eculizumab. Both patients quickly achieved remission of microangiopathic hemolytic anemia and recovery of renal function. After withdrawal of eculizumab, remission was stable over an observation period of 47 months and 15 months, respectively. Our data show that eculizumab is effective in treating chemotherapy-induced TMA. Discontinuation of eculizumab is feasible once the complement-activating condition is controlled and the trigger is eliminated. Additional studies need to determine the optimal duration of complement-directed therapies and validate effective monitoring strategies after discontinuation of such therapy.<br /> (© Dustri-Verlag Dr. K. Feistle.)