title: Pathophysiology of tumour-induced microangiopathic haemolytic anaemia.
abstract: Cancer-associated microangiopathic haemolytic anaemia (CA-MAHA) is a syndrome characterised by Coombs-negative haemolytic anaemia and thrombocytopenia. It is primarily seen in advanced solid tumours and is distinct from thrombotic thrombocytopenic purpura/haemolytic uraemic syndrome. Diagnosis is often delayed and patients have a high mortality. We present the case of CA-MAHA in a patient with metastatic breast cancer treated successfully with early initiation of chemotherapy. In addition, we report longitudinal laboratory evaluation of circulating tumour cells and microparticles and suggest a hypothesis for the mechanism behind CA-MAHA.
authors.affiliation: University of Arizona Cancer Center, Tucson, Arizona, USA.
authors.forename: Pavani
authors.identifier: http://orcid.org/0000-0002-7953-2979
authors.initials: P
authors.lastname: Chalasani
authors.affiliation: Department of Medicine, University of Arizona, Tucson, Arizona, USA.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Segar
authors.affiliation: University of Arizona Cancer Center, Tucson, Arizona, USA.
authors.forename: Marilyn
authors.initials: M
authors.lastname: Marron
authors.affiliation: Stonybrook, Stony Brook, New York, USA.
authors.forename: Alison
authors.initials: A
authors.lastname: Stopeck
mesh_terms: D000368:Aged; D000743:Anemia, Hemolytic / Q000209:etiology / Q000503:physiopathology*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000150:complications* / Q000188:drug therapy; D018275:Carcinoma, Lobular / Q000150:complications* / Q000188:drug therapy; D055252:Cell-Derived Microparticles; D003520:Cyclophosphamide / Q000627:therapeutic use; D004317:Doxorubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D009360:Neoplastic Cells, Circulating; D010257:Paraneoplastic Syndromes / Q000503:physiopathology*; D013921:Thrombocytopenia / Q000188:drug therapy / Q000209:etiology
chemical_list: D004317:Doxorubicin; D003520:Cyclophosphamide