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Hematology Reports
Volume 15
Issue 1
10.3390/hematolrep15010002
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Case Report

Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis

by
Youssef Bouferraa
1,
Yolla Haibe
1,
Hanan Hamdan
2,
Rami Mahfouz
2,
Zaher Chakhachiro
2 and
Ali Shamseddine
1,*
1
Department of Internal Medicine, Division of Hematology-Oncology, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon
2
Department of Pathology and Laboratory Medicine, American University of Beirut Medical Center, Beirut 1107 2020, Lebanon
*
Author to whom correspondence should be addressed.
Hematol. Rep. 2023, 15(1), 9-16; https://doi.org/10.3390/hematolrep15010002
Submission received: 15 July 2022 / Revised: 8 October 2022 / Accepted: 30 December 2022 / Published: 4 January 2023
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Abstract

While most cases of thrombotic microangiopathic hemolytic anemias are idiopathic, some can occur in the setting of a malignancy. Differentiating both conditions is crucial to initiate the appropriate treatment. In this case report and literature review, we discuss the occurrence of a thrombotic microangiopathy in a 61-year-old male patient with a treatment-refractory metastatic colorectal cancer invading his bone marrow. Plasmapheresis does not constitute the mainstay of treatment in this setting, as targeting the primary disease is the ultimate management. Treating the condition of our patient has been challenging as multiple lines of treatments of his primary disease had been exhausted. The discrepancy in KRAs status obtained between PCR and later NGS offered a new treatment line with Cetuximab. In this article, we will discuss the different factors that differentiate between idiopathic and cancer-induced microangiopathy. We will emphasize on the fact that the treatment of the primary disease constitutes the most important step in the treatment of cancer-induced thrombotic microangiopathy. We will also raise several explanations to target the disagreement in KRAS status obtained by the different technical modalities.
Keywords: thrombotic thrombocytopenic purpura; plasmapheresis; colorectal cancer; anemia; thrombocytopenia thrombotic thrombocytopenic purpura; plasmapheresis; colorectal cancer; anemia; thrombocytopenia

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MDPI and ACS Style

Bouferraa, Y.; Haibe, Y.; Hamdan, H.; Mahfouz, R.; Chakhachiro, Z.; Shamseddine, A. Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis. Hematol. Rep. 2023, 15, 9-16. https://doi.org/10.3390/hematolrep15010002

AMA Style

Bouferraa Y, Haibe Y, Hamdan H, Mahfouz R, Chakhachiro Z, Shamseddine A. Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis. Hematology Reports. 2023; 15(1):9-16. https://doi.org/10.3390/hematolrep15010002

Chicago/Turabian Style

Bouferraa, Youssef, Yolla Haibe, Hanan Hamdan, Rami Mahfouz, Zaher Chakhachiro, and Ali Shamseddine. 2023. "Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis" Hematology Reports 15, no. 1: 9-16. https://doi.org/10.3390/hematolrep15010002

APA Style

Bouferraa, Y., Haibe, Y., Hamdan, H., Mahfouz, R., Chakhachiro, Z., & Shamseddine, A. (2023). Thrombotic Microangiopathy in the Setting of Colorectal Cancer: A Therapeutic Challenge with a Bad Prognosis. Hematology Reports, 15(1), 9-16. https://doi.org/10.3390/hematolrep15010002

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