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Tumorassoziiertes hämolytisch-urämisches Syndrom (c-HUS) durch antineoplastische Substanzen

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Kompendium Internistische Onkologie

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Zusammenfassung

Das Chemotherapie-assoziierte hämolytisch-urämische Syndrom (c-HUS) gehört zum Formenkreis der thrombotischen Mikroangiopathien, die sich durch systemische oder renale Thrombozytenaggregation, Thrombozytopenie, mechanische Schädigung der Erythrozyten mit hämolytischer Anämie und mögliche Endorganschädigung durch Okklusionen kleiner Gefäße auszeichnen. Dem c-HUS liegt eine primäre Endothelschädigung zugrunde, was zu einem Verlust der antithrombogenen Charakteristika des Endothels führt, gefolgt von einer Freisetzung von ultralangen Multimeren des von-Willebrand-Faktors, Gefäßwandverdickung und intraluminalen Thrombozytenthromben. Typische Onkologika als Auslöser eines c-HUS sind Mitomycin C, Gemcitabine, Cisplatin sowie gegen VEGF gerichtete monoklonale Antikörper oder orale Tyrosinkinaseinhibitoren. Obwohl es sich beim c-HUS um eine sehr seltene unerwünschte Arzneimittelwirkung handelt, sollte der behandelnde Onkologe auf Zeichen eines möglichen c-HUS achten. Die Behandlung umfasst den sofortigen Therapiestopp, eine antihypertensiven Behandlung, Plasmaaustausch oder Dialyse falls indiziert. Die zusätzliche Gabe von Steroiden oder Thrombozytenaggregationshemmern bringt keinen klinischen Nutzen.

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Literatur

  • Arai Y, Aoki K, Takeda J, Kondo T, Eto T, Ota S, Hashimoto H, Fukuda T, Ozawa Y, Kanda Y, Kato C, Kurokawa M, Iwato K, Onizuka M, Ichinohe T, Atsuta Y, Takami A, Aml, M.D.S.W.G.o.J.S.f.H.C. Transplantation (2015) Clinical significance of high-dose cytarabine added to cyclophosphamide/total-body irradiation in bone marrow or peripheral blood stem cell transplantation for myeloid malignancy. J Hematol Oncol 8:102

    Article  Google Scholar 

  • Barre P, Kaplan BS, de Chadarevian JP, Drummond KN (1977) Hemolytic uremic syndrome with hypocomplementemia, serum C3NeF, and glomerular deposits of C3. Arch Pathol Lab Med 101:357–361

    CAS  PubMed  Google Scholar 

  • Bell WR, Braine HG, Ness PM, Kickler TS (1991) Improved survival in thrombotic thrombocytopenic purpura-hemolytic uremic syndrome. Clinical experience in 108 patients. N Engl J Med 325:398–403

    Article  CAS  Google Scholar 

  • Bollee G, Patey N, Cazajous G, Robert C, Goujon JM, Fakhouri F, Bruneval P, Noel LH, Knebelmann B (2009) Thrombotic microangiopathy secondary to VEGF pathway inhibition by sunitinib. Nephrol Dial Transplant 24:682–685

    Article  CAS  Google Scholar 

  • Canpolat C, Pearson P, Jaffe N (1994) Cisplatin-associated hemolytic uremic syndrome. Cancer 74:3059–3062

    Article  CAS  Google Scholar 

  • Dlott JS, Danielson CF, Blue-Hnidy DE, McCarthy LJ (2004) Drug-induced thrombotic thrombocytopenic purpura/hemolytic uremic syndrome: a concise review. Ther Apher Dial 8:102–111

    Article  CAS  Google Scholar 

  • Elliott MA, Nichols WL (2001) Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome. Mayo Clin Proc 76:1154–1162

    Article  CAS  Google Scholar 

  • Eremina V, Cui S, Gerber H, Ferrara N, Haigh J, Nagy A, Ema M, Rossant J, Jothy S, Miner JH, Quaggin SE (2006) Vascular endothelial growth factor a signaling in the podocyte-endothelial compartment is required for mesangial cell migration and survival. J Am Soc Nephrol 17:724–735

    Article  CAS  Google Scholar 

  • Flombaum CD, Mouradian JA, Casper ES, Erlandson RA, Benedetti F (1999) Thrombotic microangiopathy as a complication of long-term therapy with gemcitabine. Am J Kidney Dis 33:555–562

    Article  CAS  Google Scholar 

  • Frangie C, Lefaucheur C, Medioni J, Jacquot C, Hill GS, Nochy D (2007) Renal thrombotic microangiopathy caused by anti-VEGF-antibody treatment for metastatic renal-cell carcinoma. Lancet Oncol 8:177–178

    Article  Google Scholar 

  • Fung MC, Storniolo AM, Nguyen B, Arning M, Brookfield W, Vigil J (1999) A review of hemolytic uremic syndrome in patients treated with gemcitabine therapy. Cancer 85:2023–2032

    Article  CAS  Google Scholar 

  • Heijden M van der, Ackland SP, Deveridge S (1998) Haemolytic uraemic syndrome associated with bleomycin, epirubicin and cisplatin chemotherapy – a case report and review of the literature. Acta Oncol 37:107–109

    Google Scholar 

  • Humphreys BD, Sharman JP, Henderson JM, Clark JW, Marks PW, Rennke HG, Zhu AX, Magee CC (2004) Gemcitabinee-associated thrombotic microangiopathy. Cancer 100:2664–2670

    Article  Google Scholar 

  • Icli F, Karaoguz H, Dincol D, Demirkazik A, Gunel N, Karaoguz R, Uner A (1993) Severe vascular toxicity associated with cisplatin-based chemotherapy. Cancer 72:587–593

    Article  CAS  Google Scholar 

  • Kapiteijn E, Brand A, Kroep J, Gelderblom H (2007) Sunitinib induced hypertension, thrombotic microangiopathy and reversible posterior leukencephalopathy syndrome. Ann Oncol 18:1745–1747

    Article  CAS  Google Scholar 

  • Korec S, Schein PS, Smith FP, Neefe JR, Woolley PV, Goldberg RM, Phillips TM (1986) Treatment of cancer-associated hemolytic uremic syndrome with staphylococcal protein A immunoperfusion. J Clin Oncol 4:210–215

    Article  CAS  Google Scholar 

  • Launay-Vacher V, Janus N, Beuzeboc P, Daniel C, Ray-Coquard I, Selle F, Rey JB, Jouannaud C, Spano JP, Thery JC, Morere JF, Goldwasser F, Mir O, Oudard S, Scotte F, Dorent R, Ludwig L, Deray G, Gligorov J (2015) Renovascular safety of bevacizumab in breast cancer patients. The prognostic value of hypertension and proteinuria. Bull Cancer 102:906–914

    Article  Google Scholar 

  • Lesesne JB, Rothschild N, Erickson B, Korec S, Sisk R, Keller J, Arbus M, Woolley PV, Chiazze L, Schein PS et al (1989) Cancer-associated hemolytic-uremic syndrome: analysis of 85 cases from a national registry. J Clin Oncol 7:781–789

    Article  CAS  Google Scholar 

  • Liu K, Mittelman A, Sproul EE, Elias EG (1971) Renal toxicity in man treated with mitomycin C. Cancer 28:1314–1320

    Article  CAS  Google Scholar 

  • Maruyama K, Nakagawa N, Suzuki A, Kabara M, Matsuki M, Shindo M, Ogawa Y, Hasebe N (2017) Pazopanib-induced endothelial injury with podocyte changes. Intern Med

    Google Scholar 

  • Medina PJ, Sipols JM, George JN (2001) Drug-associated thrombotic thrombocytopenic purpura-hemolytic uremic syndrome. Curr Opin Hematol 8:286–293

    Article  CAS  Google Scholar 

  • Meng L, Romano A, Smith E, Macik G, Grosh WW (2015) Disseminated intravascular coagulation and immune hemolytic anemia, possibly evans syndrome, after oxaliplatin and bevacizumab infusion for metastatic colon adenocarcinoma: a case report and literature review. Clin Colorectal Cancer 14:e1–e3

    Article  Google Scholar 

  • Moake JL (2002) Thrombotic microangiopathies. N Engl J Med 347:589–600

    Article  CAS  Google Scholar 

  • Muller S, Schutt P, Bojko P, Nowrousian MR, Hense J, Seeber S, Moritz T (2005) Hemolytic uremic syndrome following prolonged gemcitabine therapy: report of four cases from a single institution. Ann Hematol 84:110–114

    Article  CAS  Google Scholar 

  • Noris M, Remuzzi G (2009) Atypical hemolytic-uremic syndrome. N Engl J Med 361:1676–1687

    Article  CAS  Google Scholar 

  • Regragui S, Amelal S, Astati S, Zine M, Alami Drideb N, Al Bouzidi A, Messaoudi N, Benkirane M, Doghmi K, Mikdame M (2012) Thrombotic microangiopathy with skin localization secondary to cytarabine-daunorubicin association: report of a case. Case Rep Hematol 2012:806476

    CAS  PubMed  PubMed Central  Google Scholar 

  • Schifferli JA, Peters DK (1983) Immune adherence and staphylococcus protein A binding of soluble immune complexes produced by complement activation. Clin Exp Immunol 54:827–833

    CAS  PubMed  PubMed Central  Google Scholar 

  • Shammas F, Meyer P, Heikkila R, Apeland T, Goransson L, Berland J, Kjellevold K (1997) Thrombotic microangiopathy in a patient with chronic myelogenous leukemia on hydroxyurea. Acta Haematol 97:184–186

    Article  CAS  Google Scholar 

  • Uy AL, Simper NB, Champeaux AL, Perkins RM (2009) Progressive bevacizumab-associated renal thrombotic microangiopathy. NDT Plus 2:36–39

    CAS  PubMed  Google Scholar 

  • Valavaara R, Nordman E (1985) Renal complications of mitomycin C therapy with special reference to the total dose. Cancer 55:47–50

    Article  CAS  Google Scholar 

  • Van Cutsem E, Khayat D, Verslype C, Billemont B, Tejpar S, Meric JB, Soussan-Lazard K, Assadourian S, Cartot-Cotton S, Rixe O (2013) Phase I dose-escalation study of intravenous aflibercept administered in combination with irinotecan, 5-fluorouracil and leucovorin in patients with advanced solid tumours. Eur J Cancer 49:17–24

    Article  Google Scholar 

  • Vesely SK, George JN, Lammle B, Studt JD, Alberio L, El-Harake MA, Raskob GE (2003) ADAMTS13 activity in thrombotic thrombocytopenic purpura-hemolytic uremic syndrome: relation to presenting features and clinical outcomes in a prospective cohort of 142 patients. Blood 102:60–68

    Article  CAS  Google Scholar 

  • Walter RB, Joerger M, Pestalozzi BC (2002) Gemcitabinee-associated hemolytic-uremic syndrome. Am J Kidney Dis 40:E16

    Article  Google Scholar 

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Authors and Affiliations

  1. Kantonsspital St.Gallen, St.Gallen, Schweiz

    Markus Joerger

  2. Krebsforschung Schweiz KFS, St. Gallen, Schweiz

    Thomas Cerny

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  1. Markus Joerger
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  2. Thomas Cerny
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Correspondence to Markus Joerger .

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Editors and Affiliations

  1. Abt. Hämatologie und Onkologie, Universitätsklinikum Halle-Wittenberg Klinik und Poliklinik Innere Medizin IV, Halle, Sachsen-Anhalt, Germany

    Hans-Joachim Schmoll

Section Editor information

  1. Kantonsspital St.Gallen, St.Gallen, Switzerland

    Markus Joerger

  2. Krebsforschung Schweiz KFS, St. Gallen, Schweiz

    Thomas Cerny

  3. Universitätsklinikum Hamburg-Eppendorf, II. Medizinische Klinik und Poliklinik, Hamburg, Deutschland

    Carsten Bokemeyer

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Joerger, M., Cerny, T. (2020). Tumorassoziiertes hämolytisch-urämisches Syndrom (c-HUS) durch antineoplastische Substanzen. In: Schmoll, HJ. (eds) Kompendium Internistische Onkologie . Springer Reference Medizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-46764-0_288-1

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  • DOI: https://doi.org/10.1007/978-3-662-46764-0_288-1

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  • Print ISBN: 978-3-662-46764-0

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