Thrombotic Microangiopathy in the Cancer Patient

Thrombotic microangiopathy, manifesting as thrombotic thrombocytopenic purpura (TTP) or hemolytic uremic syndrome, is a common complication in cancer patients. It shares the pathogenic microvascular occlusive lesion and many clinical manifestations as the classical TTP, but the spectrum of complications varies widely. Several subsets are seen, including a microangiopathic hemolytic anemia in advanced cancer, chemotherapeutic drug-associated microangiopathy and those with the transplant setting. The prognosis is not as favorable as in classical TTP. Anecdotal reports indicate that responses are seen with plasma exchange and with immunoadsorption.