TTP-HUS associated with sunitinib.
Thrombotic thrombocytopenic purpura-hemolytic uremic syndrome (TTP-HUS) is a rare condition that is severe and may be fatal. Adverse reactions to drugs increasingly are reported as probable causes of TTP-HUS. Many chemotherapeutic agents have also been implicated in causing TTP-HUS. We reported a woman with metastatic renal cell carcinoma who presented with TTP-HUS associated with sunitinib. She had gross hematuria and generalized edema. The hemoglobin concentration was 8.9 g/dl and the platelet count was 46,000/mm(3). Her reticulocyte count was increased to 4.1% and the peripheral blood smear revealed red blood cell fragmentation and spherocytes. The patient completely recovered after discontinuing the use of sunitinib and undergoing plasmapheresis. Because of the increasing use of sunitinib in the treatment of cancer patients, oncologists should be aware of the possibility of TTP-HUS related to sunitinib, as early recognition and prompt therapeutic intervention can be beneficial.
Choi
Moon Ki
MK
Division of Hematology-Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Hong
Jung Yong
JY
Jang
Jun Ho
JH
Lim
Ho Yeong
HY
Ann Oncol. 2007 Oct;18(10):1745-7
17890216
Semin Thromb Hemost. 2005 Dec;31(6):681-90
16388419
Oncologist. 2007 Jan;12(1):107-13
17227905
Lancet Oncol. 2007 Jul;8(7):634-41
17613425
Semin Thromb Hemost. 2007 Nov;33(8):787-97
18175284
N Engl J Med. 2008 Mar 13;358(11):1129-36
18337603
Lancet Oncol. 2007 Feb;8(2):177-8
17267332
Lancet. 2007 Dec 15;370(9604):2011-9
18083403
J Natl Cancer Inst. 2007 Jan 3;99(1):81-3
17202116
Ther Apher Dial. 2004 Apr;8(2):102-11
15255125
J Clin Oncol. 2007 Mar 1;25(7):884-96
17327610
Curr Opin Hematol. 2001 Sep;8(5):286-93
11604563