{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,3]],"date-time":"2025-10-03T09:20:57Z","timestamp":1759483257775},"reference-count":39,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2007,5,2]],"date-time":"2007-05-02T00:00:00Z","timestamp":1178064000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2007,7]]},"abstract":"<jats:p><jats:bold>BACKGROUND:<\/jats:bold> Mitomycin\u2003C\u2013associated thrombotic microangiopathy (TMA) has a poor prognosis with limited therapeutic options. Most patients die within 4\u2003months of diagnosis due to pulmonary or renal failure. Here, a patient resistant to total plasma exchange (TPE) and immunosuppressive therapy with glucocorticoids, rituximab, vincristine, and splenectomy who was successfully treated with protein\u2003A immunoadsorption is described.<\/jats:p><jats:p><jats:bold>CASE REPORT:<\/jats:bold> A 29\u2010year\u2010old woman developed a TMA after chemotherapy with mitomycin\u2003C. She presented with thrombocytopenia, pulmonary edema, hemolytic anemia with presence of schistocytes, and renal failure. Immediate TPE (&gt;120 times) and immunosuppressive therapy with glucocorticoids, however, did not improve her clinical situation. Furthermore, she was refractory to subsequent immunosuppressive therapy with rituximab and vincristine and laparoscopic splenectomy. Finally, after 12 cycles of extracorporeal protein\u2003A immunoadsorption with a commercially available immunoadsorption system (Immunosorba, Fresenius AG), platelet counts increased with disappearance of hemolytic syndromes.<\/jats:p><jats:p><jats:bold>CONCLUSION:<\/jats:bold> Extracorporeal protein\u2003A immunoadsorption with the Immunosorba system emerges as a potentially effective and safe treatment for refractory mitomycin\u2003C\u2013associated TMA with only moderate side effects. This therapeutic option may be considered at an early state of the disease to prevent extensive immunosuppression.<\/jats:p>","DOI":"10.1111\/j.1537-2995.2007.01266.x","type":"journal-article","created":{"date-parts":[[2007,5,9]],"date-time":"2007-05-09T01:39:46Z","timestamp":1178674786000},"page":"1263-1267","source":"Crossref","is-referenced-by-count":15,"title":["Protein\u2003A immunoadsorption therapy for refractory, mitomycin\u2003C\u2013associated thrombotic microangiopathy"],"prefix":"10.1111","volume":"47","author":[{"given":"Stefan","family":"Kasper","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Markus\u2003F.","family":"Neurath","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christoph","family":"Huber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthias","family":"Theobald","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Inge","family":"Scharrer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2007,5,2]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"crossref","first-page":"723","DOI":"10.1200\/JCO.1985.3.5.723","article-title":"Carcinoma\u2010associated hemolytic\u2013uremic syndrome: a complication of mitomycin\u2003C chemotherapy","volume":"3","author":"Cantrell JE","year":"1985","journal-title":"J Clin Oncol"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1985.3.2.276"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19861001)58:7<1428::AID-CNCR2820580709>3.0.CO;2-J"},{"key":"e_1_2_6_5_2","first-page":"161","article-title":"Thrombotic microangiopathy in the cancer patient including those induced by chemotherapeutic agents","volume":"24","author":"Murgo AJ","year":"1987","journal-title":"Semin Hematol"},{"key":"e_1_2_6_6_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1989.7.6.781"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2004.03412.x"},{"key":"e_1_2_6_8_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-925467"},{"key":"e_1_2_6_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2005.01350.x"},{"key":"e_1_2_6_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19930301)71:5<1882::AID-CNCR2820710527>3.0.CO;2-E"},{"key":"e_1_2_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(97)90042-1"},{"key":"e_1_2_6_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00062752-200109000-00004"},{"key":"e_1_2_6_13_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp053024"},{"key":"e_1_2_6_14_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1986.4.2.210"},{"key":"e_1_2_6_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19891001)64:7<1400::AID-CNCR2820640705>3.0.CO;2-N"},{"key":"e_1_2_6_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/jca.2920050408"},{"key":"e_1_2_6_17_2","first-page":"421","article-title":"Mitomycin\u2010induced thrombotic thrombocytopenic purpura: possible successful treatment with vincristine and cyclophosphamide","volume":"76","author":"Durand JM","year":"1991","journal-title":"Haematologica"},{"key":"e_1_2_6_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096-8652(199909)62:1<56::AID-AJH10>3.0.CO;2-5"},{"key":"e_1_2_6_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-0968.2003.00113.x"},{"key":"e_1_2_6_20_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-925477"},{"key":"e_1_2_6_21_2","first-page":"217","article-title":"Review of efficacy of rituximab and concurrent plasma exchange in the treatment of thrombotic thrombocytopenic purpura and recurrent thrombotic thrombocytopenic purpura treated repeatedly and successfully with the monoclonal antibody rituximab","volume":"4","author":"George JN","year":"2006","journal-title":"Clin Adv Hematol Oncol"},{"key":"e_1_2_6_22_2","first-page":"210","article-title":"Efficacy of rituximab and concurrent plasma exchange in the treatment of thrombotic thrombocytopenic purpura","volume":"4","author":"Hull MJ","year":"2006","journal-title":"Clin Adv Hematol Oncol"},{"key":"e_1_2_6_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-002-0502-3"},{"key":"e_1_2_6_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1538-7836.2004.00879.x"},{"key":"e_1_2_6_25_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0609.2006.00758.x"},{"key":"e_1_2_6_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-0012.2005.00334.x"},{"key":"e_1_2_6_27_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-001-0395-6"},{"key":"e_1_2_6_28_2","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705241"},{"key":"e_1_2_6_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2005.05512.x"},{"key":"e_1_2_6_30_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2003.00336.x"},{"key":"e_1_2_6_31_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.2002.00260.x"},{"key":"e_1_2_6_32_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2005.00656.x"},{"key":"e_1_2_6_33_2","doi-asserted-by":"publisher","DOI":"10.1002\/jca.10053"},{"key":"e_1_2_6_34_2","first-page":"320","article-title":"Splenectomy in relapsing and plasma\u2010refractory acquired thrombotic thrombocytopenic purpura","volume":"89","author":"Kremer Hovinga JA","year":"2004","journal-title":"Haematologica"},{"key":"e_1_2_6_35_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2005.05681.x"},{"key":"e_1_2_6_36_2","first-page":"81","article-title":"Pilot study of combined cryosupernatant and protein\u2003A immunoadsorption exchange in the treatment of grade 3\u20104 bone marrow transplant\u2010associated thrombotic microangiopathy","volume":"17","author":"Zeigler ZR","year":"1996","journal-title":"Bone Marrow Transplant"},{"key":"e_1_2_6_37_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.2006.00747.x"},{"key":"e_1_2_6_38_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1024335"},{"key":"e_1_2_6_39_2","doi-asserted-by":"crossref","first-page":"3245","DOI":"10.1182\/blood.V87.8.3245.bloodjournal8783245","article-title":"Plasma from patients with idiopathic and human immunodeficiency virus\u2010associated thrombotic thrombocytopenic purpura induces apoptosis in microvascular endothelial cells","volume":"87","author":"Laurence J","year":"1996","journal-title":"Blood"},{"key":"e_1_2_6_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2004.09.001"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1537-2995.2007.01266.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1537-2995.2007.01266.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T00:32:36Z","timestamp":1695947556000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1537-2995.2007.01266.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,5,2]]},"references-count":39,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2007,7]]}},"alternative-id":["10.1111\/j.1537-2995.2007.01266.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1537-2995.2007.01266.x","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,5,2]]}}}