CISPLATIN-ASSOCIATED HEMOLYTIC-UREMIC SYNDROME

Background. Hemolytic uremic syndrome (HUS) is an acquired disorder la rgely affecting infants and young children. It is characterized by the triad of microangiopathic hemolytic anemia, acute renal failure, and thrombocytopenia. Although its etiology is unknown, viral and bacteria l infections, disseminated malignancies in adults, and a variety of ch emotherapeutic agents including cisplatin, have been implicated in its occurrence. The association of HUS with chemotherapeutic agents after its detection in a pediatric patient treated with cisplatin is review ed. Methods. A 16-year-old male with osteosarcoma was treated with cis platin as part of a chemotherapy protocol. After the fourth course, hi s renal function deteriorated and necessitated cessation of cisplatin. Nine months after the initiation of cisplatin, HUS developed. There w as no evidence of residual tumor or metastatic disease. He received nu merous packed erythrocyte and platelet transfusions for persistent hem olysis and underwent several episodes of hemodialysis. Utilizing this patient as an example, the authors reviewed the incidence of HUS devel oping subsequent to the use of other chemotherapeutic agents. Results. In the publishing literature, chemotherapy-associated HUS has been de scribed to occur 54 days to 14 months after the initiation of chemothe rapeutic regimens. A variety of agents was associated with the phenome non. Conclusion. Hemolytic uremic syndrome may be a complication of ci splatin, as evidenced by the condition that occurred in a 16-year-old patient with osteosarcoma after cisplatin therapy.