Pegylated liposomal doxorubicin causes kidney-limited thrombotic microangiopathy Journal Article
| Authors: | Glezerman, I.; Salvatore, S.; Tap, W.; Kelly, C.; Brauer Ornelas, C. M.; Shaikh, A. |
| Article Title: | Pegylated liposomal doxorubicin causes kidney-limited thrombotic microangiopathy |
| Abstract: | A definite causal link between pegylated liposomal doxorubicin (PLD) and kidney-limited thrombotic microangiopathy (TMA) remains unestablished. Here, we report 2 cases of PLD-induced kidney-limited TMA, 1 in a patient with myxofibrosarcoma and the other in a patient with liposarcoma. The 2 patients received a high cumulative dose of PLD, and both presented with a rise in serum creatinine and proteinuria. Kidney biopsy revealed TMA with chronic mesangiolysis and capillary wall double contouring. Neither patient had concomitant exposure to TMA-causing drugs, such as gemcitabine, anti–vascular endothelial growth factor agents, or mammalian target of rapamycin inhibitors. The work-up for secondary causes of TMA was negative in both patients. The cessation of PLD therapy led to improvement or stabilization in serum creatinine and proteinuria in both patients. These 2 cases provide a clear causal link between PLD and kidney-limited TMA. The high cumulative dose of PLD increases the risk of kidney TMA. Early recognition of PLD-induced kidney TMA can lead to timely cessation of PLD therapy and potentially preserve kidney function. © 2023 National Kidney Foundation, Inc. |
| Keywords: | vasculotropin; cancer chemotherapy; clinical article; aged; cancer surgery; human cell; case report; doxorubicin; hypertension; gemcitabine; tumor localization; multiple cycle treatment; creatinine; creatinine blood level; docetaxel; lung metastasis; radical nephrectomy; pazopanib; mammalian target of rapamycin inhibitor; kidney metastasis; kidney biopsy; proteinuria; treatment withdrawal; alendronic acid; liposarcoma; omeprazole; thrombotic microangiopathy; medical history; fibromyxosarcoma; amlodipine; wedge resection; olaratumab; human; female; article; pembrolizumab; abemaciclib; epacadostat; tma, pegylated doxorubicin, acute kidney injury; protein creatinine ratio |
| Journal Title: | American Journal of Kidney Diseases |
| Volume: | 83 |
| Issue: | 4 |
| ISSN: | 0272-6386 |
| Publisher: | W.B. Saunders Co. |
| Date Published: | 2024-04-01 |
| Start Page: | 549 |
| End Page: | 553 |
| Language: | English |
| DOI: | 10.1053/j.ajkd.2023.08.014 |
| PUBMED: | 37839689 |
| PROVIDER: | scopus |
| PMCID: | PMC11670002 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK authors: Aisha Shaikh -- Source: Scopus |
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