Eculizumab therapy for gemcitabine induced hemolytic uremic syndrome: case series and concise review.

The incidence of gemcitabine-induced hemolytic uremic syndrome (GiHUS) has been reported to be between 0.02% and 2.2% (1,2). A variety of therapies have been employed in the treatment of GiHUS with varying success. In some cases the discontinuation of drug will result in remission of HUS (3). The benefit of plasmapheresis in the treatment of atypical forms of HUS (aHUS) such as GiHUS has been questioned (4). Other treatment modalities have been used with varying rates of success including high dose corticosteroids, vincristine, and rituximab (3,5). Eculizumab is a monoclonal antibody directed against the complement protein C5 that has been recently approved for treatment of atypical HUS (3). We report four cases of GiHUS seen over 2-month period and successfully treated with eculizumab.