title: Disseminated carcinoma diagnosed by bone marrow biopsy in patients with microangiopathic hemolytic anemia and thrombocytopenia: a report of two cases with gastric cancer and a review of the literature.
abstract: BACKGROUND
  Malignancy is often associated with hematological disorders, but rarely is the diagnosis of malignancy secondary to the diagnosis of microangiopathic hemolytic anemia and thrombocytopenia.
  
  
  METHODS
  We report hereby two patients with metastatic gastric carcinoma presenting with microangiopathic hemolytic anemia and thrombocytopenia. Despite chemotherapy and repeated plasmapheresis in one patient, both patients succumbed shortly after the diagnosis of cancer was made.
  
  
  CONCLUSIONS
  A review of the literature regarding microangiopathic hemolytic anemia in cancer patients is discussed. In patients suffering from microangiopathic hemolytic anemia and thrombocytopenia, malignancy should be considered as a possible cause. Early diagnosis of malignancy may be critical for determining the patient's prognosis and potentially avoiding unnecessary overtreatment.
authors.affiliation: Division of Oncology, Rambam Health Care Campus and Faculty of Medicine, Technion-Israel Institute of Technology, POB 9602, Haifa 31096, Israel.
authors.forename: Orit
authors.initials: O
authors.lastname: Kaidar-Person
authors.forename: Haitam
authors.initials: H
authors.lastname: Nasrallah
authors.forename: Nissim
authors.initials: N
authors.lastname: Haim
authors.forename: Eldad J
authors.initials: EJ
authors.lastname: Dann
authors.forename: Gil
authors.initials: G
authors.lastname: Bar-Sela
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis*; D000328:Adult; D001706:Biopsy; D001853:Bone Marrow / Q000473:pathology*; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011697:Purpura, Thrombotic Thrombocytopenic / Q000175:diagnosis* / Q000628:therapy; D013274:Stomach Neoplasms / Q000175:diagnosis*; D013921:Thrombocytopenia / Q000175:diagnosis* / Q000628:therapy
references.citation: N Engl J Med. 2006 May 4;354(18):1927-35
references.pmid: 16672704
references.citation: Crit Rev Oncol Hematol. 1991 Dec;11(4):243-65
references.pmid: 1777089
references.citation: Ann Oncol. 2008 Jun;19(6):1204-7
references.pmid: 18407952
references.citation: J Hematol Oncol. 2008 Dec 01;1:23
references.pmid: 19046460
references.citation: Semin Hematol. 1987 Jul;24(3):161-77
references.pmid: 3310241
references.citation: Arch Pathol Lab Med. 2003 Jul;127(7):834-9
references.pmid: 12823037
references.citation: N Engl J Med. 1991 Aug 8;325(6):393-7
references.pmid: 2062330
references.citation: Blood. 1984 Sep;64(3):592-8
references.pmid: 6432074
references.citation: N Engl J Med. 1998 Nov 26;339(22):1578-84
references.pmid: 9828245
references.citation: J Clin Oncol. 1989 Jun;7(6):781-9
references.pmid: 2497229
references.citation: Am J Med. 1999 Dec;107(6):573-9
references.pmid: 10625026
references.citation: Semin Thromb Hemost. 2005 Dec;31(6):681-90
references.pmid: 16388419
references.citation: Blood. 1998 Apr 15;91(8):2839-46
references.pmid: 9531594
references.citation: Haematologica. 2002 Jan;87(1):ECR01
references.pmid: 11801475
references.citation: Blood. 2010 Feb 25;115(8):1500-11; quiz 1662
references.pmid: 20032506
references.citation: Lancet Oncol. 2007 Jul;8(7):634-41
references.pmid: 17613425
references.citation: N Engl J Med. 1998 Nov 26;339(22):1585-94
references.pmid: 9828246
references.citation: JAMA. 1985 Nov 8;254(18):2554-5
references.pmid: 4057460
references.citation: N Engl J Med. 1991 Aug 8;325(6):398-403
references.pmid: 2062331
references.citation: New Istanbul Contrib Clin Sci. 1975 Jun;11(2):103-7
references.pmid: 174059
references.citation: Oncologist. 2005 Apr;10(4):299-300
references.pmid: 15821250
references.citation: Clin Nephrol. 1987 Jan;27(1):46
references.pmid: 3815908
references.citation: Cancer. 1995 Mar 1;75(5):1167-70
references.pmid: 7850716
references.citation: Blood. 2000 Aug 15;96(4):1223-9
references.pmid: 10942361
references.citation: Nature. 2001 Oct 4;413(6855):488-94
references.pmid: 11586351
references.citation: Semin Hematol. 1997 Apr;34(2):159-66
references.pmid: 9109218
references.citation: Oncologist. 2007 Jan;12(1):11-9
references.pmid: 17227897
references.citation: Hematopathol Mol Hematol. 1996;10(3):161-70
references.pmid: 8878734
references.citation: Ther Apher Dial. 2010 Apr;14(2):222-5
references.pmid: 20438546