Cancer Drug induced TMA come in 2 variants
1.
Type 1 TMA:- onset is delayed, usually 6-12
months after starting therapy
Cumulative dose related
Clinically, could be permanent and
irreversible renal damage
Would avoid rechallenge
High incidence of acute mortality and may
require dialysis even after stopping agent
Thrombi in both arteriole and glomerular
capillary
Examples:
Mitomycin C and gemcitabine induced
2.
Type 2 TMA:- onset is more acute and only at
time of initiation of agent.
Not dose related
High likelihood of recovery
Some evidence of safe rechallenge
Thrombi in glomerular capillary mainly
Patient and kidney survival excellent
Examples: anti VEGF and TKI agents induced
No comments:
Post a Comment