Thrombotic microangiopathy as a complication of long-term therapy with gemcitabine

Three patients with pancreatic carcinoma treated with gemcitabine for 1 yea r developed clinical and laboratory findings compatible with an indolent fo rm of the hemolytic-uremic syndrome. Renal biopsy specimens in two of these patients showed the characteristic features of thrombotic microangiopathy, and a skin biopsy specimen from the third patient, who presented with live do reticularis, showed intravascular fibrin deposition. Thrombotic microang iopathy may represent a toxic effect of long-term gemcitabine therapy. (C) 1999 by the National Kidney Foundation, Inc.