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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Thrombotic microangiopathy (TMA) is a rare complication in cancer and cancer therapy. However, characteristics and outcomes of cancer-associated TMA remain limited.
We conducted a single-center retrospective study of adult patients (≥18 years) diagnosed with TMA or thrombotic thrombocytopenic purpura (TTP) based on ICD-10 codes between January 1, 2000, and June 30, 2025, at the University of Minnesota, MN, USA. We included patients that had a cancer diagnosis before or at the time of TMA. Those with TMA preceding cancer were excluded. Baseline characteristics, treatments, and outcomes were collected. Patients were classified into cancer-associated TMA (CA-TMA), chemotherapy-associated TMA (CH-TMA), or other TMA. We compared characteristics and outcomes between CA-TMA and CH-TMA groups. Hematologic response was defined as platelet ≥150×10³/µL and renal response as ≥25% reduction in creatinine (Cr) from peak.
Between 2000-2025, there were 89 patients fulfilling inclusion and exclusion criteria. Of these, 22 (24.7%) had CA-TMA, 26 had (29.2%) CH-TMA, and 41 had (46.1%) other TMAs. Among CA-TMA, 9.1% had TTP; among CH-TMA, 7.7% had TTP and 7.7% renal-limited TMA. Age, race, and comorbidities were similar between CA- and CH-TMA. Females were more frequent in CH-TMA (65.4% vs. 40.9%, p=0.09). Time from cancer to TMA diagnosis was shorter in CA-TMA (0.7 vs. 1.1 years, p=0.05). Gastrointestinal (GI) malignancies were most common in CH-TMA (50%), while hematologic cancers predominated in CA-TMA (50%), followed by GI malignancies. Rates of metastasis and bone metastasis were similar.
Renal involvement occurred in 87.5% of patients, with 37.5% having stage 3 acute kidney injury (AKI). CH-TMA presented with higher serum Cr (2.64 vs. 1.59 mg/dL, p=0.05) and tended to be in stage 3 AKI (46.2% vs. 27.3%, p=0.23). Proteinuria did not differ (urine protein/creatinine ratio 0.6 vs. 0.75 g/g). Complement genetic testing was performed in 10% and was normal in all. Among 8 patients tested for sC5b-9, two (25%) were positive. Plasmapheresis was used in 20.8%, and C5 inhibitors in 12.5% (6 patients with three in each group). Patients receiving C5 inhibitors had higher baseline Cr (8.71 vs. 1.66 mg/dL, p<0.01) but no difference in hematologic parameters. No difference in renal response between CA- and CH-TMA (41.2% vs. 28.0%, p=0.15). However, in C5 inhibitor users, none of the CA-TMA patients achieved renal response, while 67% (2/3 patients) of CH-TMA did. Nine patients (18.7%) required dialysis; one successfully discontinued. Of three dialysis patients treated with C5 inhibitors, one (33.3%) recovered renal function.
Among patients treated with C5 inhibitors, mortality was lower (17% vs. 61.9%, p=0.03). Overall, 56.3% of patients died, with no difference between CA- and CH-TMA. Leading causes of death were cancer progression (59.3%), infection (22.2%), and TMA (7.4%).
CA-TMA and CH-TMA differ in cancer type and clinical presentation. CH-TMA was mainly associated with GI malignancies and showed more severe renal involvement but better renal recovery. Nearly one-fifth required dialysis. C5 inhibition may benefit in selected CH-TMA patients. Both CA- and CH-TMA carried a poor prognosis, with mortality approaching 60%.
