Thrombotic Microangiopathy after Allogeneic Blood and Marrow Transplantation Is Associated with Dose-Intensive Myeloablative Conditioning Regimens, Unrelated Donor, and Methylprednisolone T-Cell Depletion

Abstract

Avoidance of high-intensity conditioning regimens may decrease the incidence of allogeneic BMT-associated TM.

Clinical impact of thrombotic microangiopathy on the outcome of patients with acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation

“…death in 1 out of 19 (5%), 33 2 out of 13 (15%), 14 none of six (0%), 34 and 4 out of 19 (21%) patients. 15 On the other hand, in this study, TMA was a contributing cause in 15 out of 27 (56%) patients who died after being diagnosed with TMA, which revealed the clinical impact of TMA in patients with acute GVHD.…”

“…[13][14][15][16] The reported incidence of TMA varies from 0.5 to 76%. [13][14][15][16][28][29][30][31][32][33][34] A recent literature review identified 447 (8.2%) cases of TMA, with a median mortality of 75% within 3 months of the diagnosis. 35 The large variability in the published incidence is due to the fact that there are no uniformly accepted diagnostic criteria for this clinical syndrome.…”

Clinicopathological manifestations and treatment of intestinal transplant-associated microangiopathy

“…Although its etiology and pathogenesis have not been fully clarified, endothelial damage induced by multiple factors, such as conditioning regimens, GVHD, immunosuppressants and infection, contributes to its development. [6][7][8][9][10][11][12][13][14][15] Management of TAM is supportive, and withdrawal or decreasing the dose of calcineurin inhibitors is suggested as the first step in the treatment. 4,10 Severe diarrhea is a serious symptom after allo-HSCT.…”

Transplant-associated microangiopathy (TAM) in recipients of allogeneic hematopoietic stem cell transplants

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20] Thrombotic microangiopathy is characterized by systemic or intrarenal platelet aggregation and a microangiopathic hemolytic anemia, with red blood cell (RBC) fragmentation and a negative direct antiglobulin test. Increased platelet consumption leads to thrombocytopenia.…”