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Abstract：
Thrombotic microangiopathy (TMA) is an anatomopathological lesion mediated by endothelial dysfunction and characterized by the creation of microthrombi in small vessels. In patients with cancer, it may be due to toxicity secondary to chemotherapy, tumor embolization, or hematopoietic progenitor transplantation. Cancer-associated TMA is an underestimated entity that generally appears in the final stages of the disease, although it may also be the initial manifestation of an underlying cancer. Support treatment is necessary in all cases and, depending on the cause, different targeted therapies may be used. The prognosis is very poor. In this article we present a comprehensive review of the existing literature on the physiological mechanisms of cancer-associated TMA. Afterwards, five clinical cases will be presented of patients who developed TMA and were diagnosed in our Department in 2023. We present a discussion of the different causes that triggered the condition, the possible reasons behind the underestimation of this pathology, and the measures that may be adopted.
摘要：
血栓性微血管病（TMA）是由内皮功能障碍介导的解剖病理学病变，其特征是在小血管中产生微血栓。在癌症患者中，这可能是由于化疗后的毒性，肿瘤栓塞,或造血祖细胞移植。癌症相关的TMA是一种被低估的实体，通常出现在疾病的最后阶段，尽管它也可能是潜在癌症的最初表现。支持治疗在所有情况下都是必要的，根据原因，可以使用不同的靶向治疗。预后很差。在本文中，我们对有关癌症相关TMA的生理机制的现有文献进行了全面综述。之后,5例临床病例将介绍发生TMA的患者,并于2023年在我们科室确诊.我们讨论了引发这种情况的不同原因，低估这种病理背后的可能原因，以及可能采取的措施。
