title: Treatment of mitomycin-associated microangiopathic hemolytic anemia with vincristine.
abstract: A syndrome, including microangiopathic hemolytic anemia (MAHA), thrombocytopenia, and renal insufficiency, has been recognized to occur as a complication of antineoplastic therapy with mitomycin. The clinical presentation can vary from a chronic course with mild anemia and slowly progressive renal dysfunction to a fulminant course with severe anemia, rapid deterioration of renal function, and death. The optimal treatment of the mitomycin-associated MAHA syndrome is unknown. Therapy with steroids, antiplatelet agents, and heparin sodium has failed to reverse the MAHA. Plasmapheresis has improved the MAHA in a few patients without reversing the renal failure. We treated two patients who had MAHA and renal dysfunction during chemotherapy that included mitomycin; the MAHA and hypertension both objectively improved after treatment that included vincristine sulfate.
mesh_terms: D058186:Acute Kidney Injury / Q000188:drug therapy / Q000209:etiology; D000230:Adenocarcinoma / Q000188:drug therapy; D000328:Adult; D000743:Anemia, Hemolytic / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced / Q000188:drug therapy / Q000209:etiology; D008937:Mitomycins / Q000009:adverse effects*; D009362:Neoplasm Metastasis; D013577:Syndrome; D013921:Thrombocytopenia / Q000188:drug therapy; D014750:Vincristine / Q000627:therapeutic use*
chemical_list: D008937:Mitomycins; D014750:Vincristine