Grall M, Daviet F, Chiche NJ, et al. - Whether eculizumab, a monoclonal antibody targeting the terminal complement pathway, has efficacy in treating patients with gemcitabine-induced thrombotic microangiopathy (TMA) [G-TMA], was assessed in this observational, retrospective, multicenter study conducted in 5 French centres between 2011 and 2016. This analysis involved 12 patients with a G-TMA managed by eculizumab. Eculizumab was initiated following a median of 15 days (range 4–44) post-TMA diagnosis. Patients were administered a median of 4 injections of eculizumab (range 2–22). Ten patients (83%) achieved complete hematological remission and only one injection of eculizumab resulted in significant reduction of blood transfusion. At the end of the follow up, patients in the eculizumab group and in the control group were found to have median estimated glomerular filtration rate of 45 vs 33 ml/min/1.73m ² respectively. Overall, eculizumab was not only efficient on haemolysis but also decreased transfusion needs in G-TMA. In addition, improvement in renal function recovery may be conferred by eculizumab.