Cantrell J E, Phillips T M, Schein P S
J Clin Oncol. 1985 May;3(5):723-34. doi: 10.1200/JCO.1985.3.5.723.
A thrombotic microangiopathy resembling the hemolytic uremic syndrome was diagnosed in 12 patients with adenocarcinoma, in whom the tumor was in complete or near-complete remission after treatment with mitomycin C-containing drug regimens. Microangiopathic hemolytic anemia, thrombocytopenia, and renal failure were initially present in all cases. All patients eventually developed pulmonary edema and systemic arterial hypertension, and three experienced neurologic complications. Blood transfusions exacerbated the syndrome in nine patients. High titers of platelet-aggregating plasma immune complexes were present in all six cases in which they were measured. The constituent antibody of each complex failed to react with mitomycin C antigen preparations, whereas in vitro reactivity to endodermally derived neoplasms was demonstrated. Plasmapheresis was associated with amelioration of the syndrome in only one patient. In patients receiving mitomycin C chemotherapy, the development of anemia and thrombocytopenia or azotemia may represent the initial manifestations of this newly defined thrombotic microangiopathy. A consistently effective form of management of this syndrome has not as yet been defined.
12例腺癌患者被诊断出患有类似溶血性尿毒症综合征的血栓性微血管病，这些患者在接受含丝裂霉素C的药物治疗方案后，肿瘤处于完全或接近完全缓解状态。所有病例最初均出现微血管病性溶血性贫血、血小板减少和肾衰竭。所有患者最终均出现肺水肿和系统性动脉高血压，3例出现神经系统并发症。输血使9例患者的综合征加重。在检测的所有6例病例中均存在高滴度的血小板聚集血浆免疫复合物。每种复合物的组成抗体均未与丝裂霉素C抗原制剂发生反应，而在体外显示出对内胚层来源肿瘤的反应性。血浆置换仅在1例患者中与综合征的改善相关。在接受丝裂霉素C化疗的患者中，贫血、血小板减少或氮质血症的出现可能代表这种新定义的血栓性微血管病的初始表现。尚未确定一种始终有效的该综合征治疗方式。
