Reduction in the Prevalence of Thrombotic Events in Sickle Cell Disease after Allogeneic Hematopoietic Transplantation.

Autor: Patel A; Department of Hematology and Bone Marrow Transplant, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: ameet.patel@vumc.org., Wilkerson K; Department of Hematology/Oncology, Vanderbilt-Meharry Sickle Cell Center of Excellence, Vanderbilt University Medical Center, Nashville, Tennessee., Chen H; Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee., Sharma D; Department of Hematology and Bone Marrow Transplant, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Hematology/Oncology, Vanderbilt-Meharry Sickle Cell Center of Excellence, Vanderbilt University Medical Center, Nashville, Tennessee., Byrne M; Department of Hematology and Bone Marrow Transplant, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee., Green J; Department of Hematology and Bone Marrow Transplant, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee., Sengsayadeth S; Department of Hematology and Bone Marrow Transplant, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Hematology/Stem Cell Transplant, Veteran Hospital Administration, Nashville, Tennessee., Dholaria B; Department of Hematology and Bone Marrow Transplant, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee., Savani B; Department of Hematology and Bone Marrow Transplant, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Hematology/Stem Cell Transplant, Veteran Hospital Administration, Nashville, Tennessee., Chinratanalab W; Department of Hematology/Stem Cell Transplant, Veteran Hospital Administration, Nashville, Tennessee., Jayani R; Department of Hematology and Bone Marrow Transplant, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee., Gatwood K; Department of Pharmaceutical Services, Vanderbilt University Medical Center, Nashville, Tennessee., Engelhardt BG; Department of Hematology and Bone Marrow Transplant, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee., Kitko C; Division of Hematology/Oncology and Bone Marrow Transplant, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee., Connelly J; Division of Hematology/Oncology and Bone Marrow Transplant, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee., Kassim A; Department of Hematology and Bone Marrow Transplant, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Hematology/Oncology, Vanderbilt-Meharry Sickle Cell Center of Excellence, Vanderbilt University Medical Center, Nashville, Tennessee.
Jazyk: angličtina
Zdroj: Transplantation and cellular therapy [Transplant Cell Ther] 2022 May; Vol. 28 (5), pp. 277.e1-277.e6. Date of Electronic Publication: 2022 Feb 15.
DOI: 10.1016/j.jtct.2022.02.010
Abstrakt: Thrombosis is a recognized complication in sickle cell disease (SCD). Allogeneic hematopoietic cell transplantation (allo-HCT) remains the sole curative option for patients with severe SCD phenotypes. Data describing the effects of allo-HCT on recurrent thrombotic events (venous and arterial events) are limited, however. We evaluated 31 patients with SCD who underwent allo-HCT with a median follow-up of 34.5 months (range, 13 to 115) post-transplantation. No patient continued anticoagulation or antiplatelet therapy after allo-HCT. There was an absolute difference of 32% (95% confidence interval [CI], 12.3% to 32.2%; P = .002) in the prevalence of venous thromboembolic (VTE) events before and after allo-HSCT. In addition, there was an absolute difference of 38.5% (95% CI, 10.63 to 45.96; P = .006) in the number of ischemic cerebrovascular accidents (CVAs) occurring before and after allo-HSCT. Patients with severe SCD who undergo allo-HCT are less likely to develop recurrent thrombotic events compared with a control cohort of patients matched for age and genotype (odds ratio, 0.22; 95% CI, 0.058 to 0.83; P = .025). Following curative therapy with allo-HCT, there is a reduction in recurrent arterial and venous thrombosis in patients with severe SCD phenotypes.
(Copyright © 2022 The American Society for Transplantation and Cellular Therapy. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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