Cisplatin and Short-Term 5-Fluorouracil Infusion for Paraneoplastic Microangiopathic Hemolytic Anemia in Gastric Cancer: A Case Report and Review of the Literature

Table 1

Reference	Age	M/F	Hb (g/L)	Platelets (×10^9/L)	Plasma-pheresis	Hematological diagnosis	Chemotherapy 1st line	Subsequent chemotherapy	Approximate survival from the beginning of the first therapy for hemolysis (if applicable) or presentation
[9]	70	M	72	80	Yes	TTP	Carboplatin/paclitaxel		14 days
[10]	52	F	72	62	No	MAHA	None		1 week
[10]	28	M	75	77	No	MAHA	None		1 week
[10]	21	M	61	342	No	MAHA	None		1 week
[8]	62	M	107	86	No	MAHA	Etoposide 120 mg/m^2, leucovorin 300 mg/m^2, and 5-FU 500 mg/m^2 days 1–3, every 21 days	5-FU 2000 mg/m^2, leucovorin 500 mg/m^2, oxaliplatin 130 mg/m^2 day 1 every 14 days	12 months
[11]	19	M	100	98	No	MAHA with DIC	5-FU, adriamycin, and mitomycin-C		6 days
[12]	61	F	95 est	NR	No	Cancer-related thrombotic microangiopathy	Infusional 5-FU 250 mg/m^2/day		35 days
[13]	60	M	82	43	Yes	TTP	5-FU, adriamycin, and mitomycin C		6 months
[14]	59	F	61	20	Yes	TTP	None		1 month
[14]	65	F	80	86	No	TTP	Paclitaxel		11 months
[15]	52	M	60	24	Yes	MAHA without DIC	None		4 weeks
[16]	75	M	81	NR	No	MAHA	None		20 days
[17]	58	F	58	14	No	MAHA	5-FU, vincristine, methotrexate, and cyclophosphamide		10 days
[18]	50	M	73	50	Yes	Cancer-associated MAHA	Docetaxel, 5-FU, and platinum		12 days
[4]	71	M	44	18	No	TTP	None		Curative-intent surgery
[19]	25	F	74	100	No	MAHA	5-FU 600 mg/m^2 weekly + adriamycin 40 mg/m^2 day 1, q21 days	Mitomycin-C 10 mg/m^2 monthly	7 months
[20]	28	F	52	111	Yes	TTP	Cisplatin/5-FU infusion		Under 2 months
[7]	45	M	59	50	No	MAHA and thrombocytopenia	Cisplatin 60 mg/m^2 day 1, 5-FU 600 mg/m^2/day infusion days 1–4, every 21 days		7 weeks
[7]	32	F	NR	NR	Yes	MAHA and thrombocytopenia	Cisplatin 20 mg/m^2 days 1–5, etoposide 60 mg/m^2 days 1–5, every 21 days	5-FU 298 (=70% of 425) mg/m^2 and leucovorin 20 mg/m^2 days 1–5, and weekly cetuximab 500 mg IV, all every 21 days	12 weeks approx..
[5]	71	F	56	15.6	No	MAHA	Mitomycin-C 10 mg and neothramycin (also gabexate infusion), 5 doses over 2 months		3 months
[6]	69	M	65	64	Yes	Thrombotic microangiopathy with renal failure	N/A		Curative intent surgery
[21]	60	M	98	35	No	DIC	None		24 days
[22]	83	F	40	85	No	MHA	None		3 days
[23]	47	F	49	9	No	MAHA	Cisplatin 80 mg/m^2 day 1, 5-FU 1000 mg/m^2/day, days 1–5	FOLFIRI, DCF at 20% dose reduction	19 months
[24]	69	F	96	104	No	MAHA	Adriamycin		4 weeks
[25]	44	M	74	71	No	MAHA and DIC	None		3 months
[26]	57	M	58	39	No	DIC	Methotrexate 100 mg/m^2 day 1, 5-FU bolus 600 mg/m^2 day 1, LV 10 mg/m^2 q6h days 2 and 3, weekly		10 months
[27]	52	F	68	18	No	Thrombotic microangiopathy	5-FU, cisplatin, and hydroxyurea		3 months
[27]	51	M	74	74	No	Thrombotic microangiopathy	Gemcitabine, oxaliplatin, irinotecan, 5-FU, and docetaxel (details not reported)		4 months
[27]	59	M	66	39	Yes	Thrombotic microangiopathy	None		44 days
[28]	51	F	67	40	Yes	TTP	Vincristine 2 mg	Cisplatin 50 mg/m^2days 1 + 15, 5-FU 150 mg/m^2, and LV 500 mg weekly	3 months
[29]	59	F	86	23	No	DIC	None		10 days
[29]	51	F	39	120	No	DIC	None		22 days
[29]	46	F	115	59	No	DIC	None		8 days
[30]	43	M	53	NR	No	HUS	None		Surgery, no recurrence
[31]	66	M	70	250	No	MAHA	5-FU 425 mg/m^2 and leucovorin 20 mg/m^2 daily	5-FU 425 mg/m^2 and leucovorin 20 mg/m^2 daily	26 months
[32]	NR	NR	43	45	No	MAHA	Cisplatin/5-FU		2 days
[33]	50	M	85	95	No	Pulmonary tumour Thrombotic microangiopathy	5-FU 250 mg daily, mitomycin C 7 mg weekly, and cisplatin 125 mg once		86 days
[34]	66	M	73	28	No	Hemol. anemia	None		15 days
[34]	43	M	91	50		Hemol. anemia	None		7 days
[35]	43	M	78	62	No	DIC/MAHA	MMC, 5-FU, Ara-C, and heparin		6 months
[36]	27	F	72	23	Yes	Thrombotic microangiopathy	None		3 days
Our case	49	M	52	76	Yes	CR-MAHA	Cisplatin 50 mg/m^2day 1, 5-FU infusion 1000 mg/m^2/day, days 1 through 4, all every 21 days	Docetaxel 25 mg/m^2 weekly, cisplatin 60 mg/m^2 every 21 days, and 200 mg/m^25-FU infusion daily	16 months

CR: cancer-related; DIC: disseminated intravascular coagulation; 5-FU: 5-fluorouracil; HUS: hemolytic uremic syndrome; MAHA: microangiopathic hemolytic anemia; MMC: mitomycin-C; TTP: thrombotic thrombocytopenic purpura.