Posado-Domínguez L, Chamorro A-J, Del Barco-Morillo E, Martín-Galache M, Bueno-Sacristán D, Fonseca-Sánchez E, Olivares-Hernández A
Medical Oncology Department, University Hospital of Salamanca, 37007 Salamanca, Spain.
Biomedical Institute Research of Salamanca (IBSAL), 37007 Salamanca, Spain.
Life (Basel). 2024 Jul 10;14(7):865. doi: 10.3390/life14070865.
Thrombotic microangiopathy (TMA) is an anatomopathological lesion mediated by endothelial dysfunction and characterized by the creation of microthrombi in small vessels. In patients with cancer, it may be due to toxicity secondary to chemotherapy, tumor embolization, or hematopoietic progenitor transplantation. Cancer-associated TMA is an underestimated entity that generally appears in the final stages of the disease, although it may also be the initial manifestation of an underlying cancer. Support treatment is necessary in all cases and, depending on the cause, different targeted therapies may be used. The prognosis is very poor. In this article we present a comprehensive review of the existing literature on the physiological mechanisms of cancer-associated TMA. Afterwards, five clinical cases will be presented of patients who developed TMA and were diagnosed in our Department in 2023. We present a discussion of the different causes that triggered the condition, the possible reasons behind the underestimation of this pathology, and the measures that may be adopted.
血栓性微血管病（TMA）是一种由内皮功能障碍介导的解剖病理学病变，其特征是在小血管中形成微血栓。在癌症患者中，它可能是由于化疗、肿瘤栓塞或造血祖细胞移植引起的毒性反应。癌症相关的TMA是一种被低估的疾病，通常出现在疾病的晚期，尽管它也可能是潜在癌症的初始表现。在所有情况下都需要支持治疗，根据病因，可能会使用不同的靶向治疗方法。预后非常差。在本文中，我们对现有关于癌症相关TMA生理机制的文献进行了全面综述。之后，将介绍2023年在我们科室诊断出患有TMA的5例临床病例。我们对引发该病的不同原因、这种病理被低估的可能原因以及可能采取的措施进行了讨论。
