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World Journal of Gastrointestinal Oncology 2020年第11期12卷 1288-1295页

作者： Anne Katrin Berger Michael Allgäuer Leonidas Apostolidis Anna Elisa Schulze-Schleithoff Uta Merle Dirk Jaeger Georg Martin Haag Department of Medical Oncology National Center for Tumor DiseasesUniversity Hospital of HeidelbergHeidelberg 69120Germany Department of Pathology Institute of PathologyUniversity Hospital of HeidelbergHeidelberg 69120Germany Department of Gastroenterology University Hospital of HeidelbergHeidelberg 69120Germany Department of Gastroenterology and Hepatology University Hospital of HeidelbergHeidelberg 69120Germany

BACKGROUND Microangiopathic hemolytic anemia(MAHA) with thrombocytopenia and organ failure caused by tumor-associated thrombotic microangiopathy(TMA) is a lifethreatening oncological emergency. Rapid diagnosis and precise distinction from other forms of TMA is crucial for appropriate therapy, which aims at treating the underlying malignancy. However, the prognosis of patients with cancer-related(CR)-MAHA is limited. To date, less than 50 patients with gastric cancer and CRMAHA have been reported, mainly as single case reports, and detailed information on treatment strategies and outcome are scarce. We analyzed the characteristics and outcomes data of CR-MAHA patients with gastric cancer treated at our center between 2012 and *** To gain knowledge about CR-MAHA and the course of *** We retrospectively analyzed patients using an institutional prospectively maintained database. Patients who had CR-MAHA but other cancer types or cancer of unknown primary were excluded. The basic requirements for inclusion were: Histologically proven gastric adenocarcinoma;and clinical diagnosis of hemolytic anemia with schistocytes with or without thrombocytopenia. The observation period for each patient started with the first day of documented symptoms. The follow-up period for this analysis ended on February 1, *** We identified eight patients with a median age of 54 years. Histologically, all patients had(partial) diffuse subtypes of gastric adenocarcinoma with partial or complete signet cell morphology. All patients had metastatic disease and one patient had a microsatellite instability-high(MSI-H) tumor. In three patients, clinical signs of MAHA preceded the diagnosis of cancer, and in two patients, CRMAHA indicated recurrent disease. All patients had severe hemolytic anemia and thrombocytopenia. Six patients experienced severe bone pain, and five patients had dyspnea. Systemic, 5-fluorouracil-based combination chemotherapy was initiated in six patients, w

关键词： Microangiopathic hemolytic anemia Gastric cancer chemotherapy secondline chemotherapy Thrombocytopenia Microsatellite instability-high tumor

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