CANCER-ASSOCIATED MICROANGIOPATHIC HEMOLY TIC-ANEMIA - SYMPTOMATIC TREATMENT WITH PLASMAPHERESIS

Objective. - to determine the interest of plasmapheresis in the manage ment of cancer-associated microangiopathic haemolytic anaemia (MHA) no t due to cancer treatment. Material and methods. - National retrospect ive study using the file of the French Hemapheresis Society. Results. - We isolated 6 patients (5 men and a woman aged 32 to 69-year-old) wh o had prostatic (4 cases) or breast carcinomas or Hodgkin's disease. D iagnosis of cancer preceeded MHA in 3 patients (from 2 to 4 years). Bo ne or bone marrow metastases were demonstrated in 5 patients. The clin ical presentation included anuria (4 cases), bleeding (4 cases), and l aboratory findings were consistent with microangiopathic haemolysis an d thrombopenia in all cases and intravascular coagulation (2 cases) an d/or renal failure (4 cases). MHA symptomatic treatment included 4 to 10 courses of plasmapheresis, extra-renal epuration (4 patients), anti coagulation (4 patients) and/or antiagregant (3 cases), haemodialysis (4 cases) and vincristine (2 cases). Cancer treatment consiste4d fo an titumoural chemotherapy (2 cases) and/or hormonotherapy (5 cases). In all cases, haemolysis, thrombopenia and intravascular coagulation were controlled within 30 days. MHA treatment was effective alone in 3 pat ients. No relapse were observed in 3 patients whereas the course of ca ncer continued in 2 patients. Two patients relapsed and died from MHA after 4 and 36 months. Two patients relapsed and died from MHA within a few months and 1 was lost to follow-up. Conclusion. - Symptomatic tr eatment of cancer-associated MHA including plasmapheresis may be usefu l while waiting for an aetiologic management of the tumour.