{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T23:44:07Z","timestamp":1792539847286,"version":"4.5.0"},"reference-count":27,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2016,7,4]],"date-time":"2016-07-04T00:00:00Z","timestamp":1467590400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:p>A variety of medications have been implicated in the causation of thrombotic microangiopathy (TMA). Recently, a few case reports have emerged of TMA attributed to the proteasome inhibitors (PI) bortezomib and carfilzomib in patients with multiple myeloma. The aim of this case series was to better characterize the role of PI in the etiology of drug\u2010induced TMA. We describe eleven patients from six medical centers from around the world who developed TMA while being treated with PI. The median time between medication initiation and diagnosis of TMA was 21 days (range 5 days to 17 months). Median laboratory values at diagnosis included hemoglobin\u20147.5 g\u00a0dL<jats:sup>\u22121<\/jats:sup>, platelet count\u201420 \u00d7 10<jats:sup>9<\/jats:sup>\/L, LDH\u2014698 U\u00a0L<jats:sup>\u22121<\/jats:sup>, creatinine\u20143.12 mg\u00a0dL<jats:sup>\u22121<\/jats:sup>. No patient had any other cause of TMA, including ADAMTS13 inhibition, other malignancy or use of any other medication previously associated with TMA. Nine patients had resolution of TMA without evidence of hemolysis after withdrawal of PI. Two patients had stabilization of laboratory values but persistent evidence of hemolysis despite medication withdrawal. One patient had recurrence of TMA with rechallenge of PI. There is a strong level of evidence that PI can cause DITMA. In evaluating patients with suspected TMA, PI use should be recognized as a potential etiology, and these medications should be discontinued promptly if thought to be the cause of TMA. Am. J. Hematol. 91:E348\u2013E352, 2016. \u00a9 2016 Wiley Periodicals, Inc.<\/jats:p>","DOI":"10.1002\/ajh.24447","type":"journal-article","created":{"date-parts":[[2016,6,11]],"date-time":"2016-06-11T03:01:48Z","timestamp":1465614108000},"source":"Crossref","is-referenced-by-count":107,"title":["Proteasome inhibitor associated thrombotic microangiopathy"],"prefix":"10.1002","volume":"91","author":[{"given":"Jennifer C.","family":"Yui","sequence":"first","affiliation":[{"name":"Department of Medicine Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Van Keer","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospitals Leuven Leuven Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brendan M.","family":"Weiss","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Abramson Cancer Center University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam J.","family":"Waxman","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, Abramson Cancer Center University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew B.","family":"Palmer","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine University of Pennsylvania Philadelphia Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivette D.","family":"D'Agati","sequence":"additional","affiliation":[{"name":"Department of Pathology and Cell Biology Columbia University Medical Center New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efstathios","family":"Kastritis","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics National and Kapodistrian, University of Athens, School of Medicine Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meletios A.","family":"Dimopoulos","sequence":"additional","affiliation":[{"name":"Department of Clinical Therapeutics National and Kapodistrian, University of Athens, School of Medicine Athens Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ravi","family":"Vij","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology Washington University School of Medicine St. Louis Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dhruv","family":"Bansal","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology Washington University School of Medicine St. Louis Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Dingli","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samih H.","family":"Nasr","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson","family":"Leung","sequence":"additional","affiliation":[{"name":"Division of Hematology Mayo Clinic Rochester Minnesota"},{"name":"Division of Nephrology and Hypertension Mayo Clinic Rochester Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,7,4]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1312353"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajh.23960"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-135-12-200112180-00008"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM200006153422402"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/ajkd.2000.17690"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.20290"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/10428194.2014.977887"},{"key":"e_1_2_6_9_1","first-page":"1136","article-title":"Bortezomib\u2010induced thrombotic thrombocytopaenic purpura","volume":"10","author":"Mehta N","year":"2012","journal-title":"BMJ case Rep"},{"key":"e_1_2_6_10_1","doi-asserted-by":"crossref","first-page":"e13","DOI":"10.4081\/hr.2012.e13","article-title":"Thrombotic microangiopathy associated with bortezomib treatment in a patient with relapsed multiple myeloma","volume":"4","author":"Salmenniemi U","year":"2012","journal-title":"Hematol Rep"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1445-5994.2011.02458.x"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12185-008-0140-1"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfv059"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21371"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2016.03.002"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21254"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra1011442"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa043445"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa030288"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2012.09232.x"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2012-05-425934"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.3324\/haematol.2013.089334"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.2147\/tcrm.2006.2.3.271"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-11-611335"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-129-11_Part_1-199812010-00009"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/143426"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-013-0893-0"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.5414\/CN107579"}],"container-title":["American Journal of Hematology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fajh.24447","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fajh.24447","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ajh.24447","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T12:49:06Z","timestamp":1695559746000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ajh.24447"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,4]]},"references-count":27,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2016,9]]}},"alternative-id":["10.1002\/ajh.24447"],"URL":"https:\/\/doi.org\/10.1002\/ajh.24447","archive":["Portico"],"relation":{},"ISSN":["0361-8609","1096-8652"],"issn-type":[{"value":"0361-8609","type":"print"},{"value":"1096-8652","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,4]]}}}