| Autor: |
Vasu, Sumithira, Bostic, Matthew, Zhao, Qiuhong, Sharma, Nidhi, Puto, Marcin, Knight, Samantha, Scott, Denise, Guzman, Rosalyn, Kromer, Meghan, Tackett, Karen, Lind, Kristin, Knill, Kathryn, Watson, Emily, Wall, Sarah, Saad, Ayman, Choe, Hannah, Larkin, Karilyn, Brammer, Jonathan, Jaglowski, Samantha, Penza, Sam, Davies, Stella M, Cataland, Spero |
| Zdroj: |
Blood Advances; 20210101, Issue: Preprints |
| Abstrakt: |
Hematopoietic cell transplantation associated thrombotic microangiopathy (TMA) is a complication associated with higher non-relapse mortality (NRM) in allogeneic transplant (HCT) patients. Current classification criteria are not generally agreed upon or validated, and presence of confounding factors post-transplant contribute to under-diagnosis or delayed diagnosis of TMA. We studied risk factors, incidence and biomarkersof TMA in 119 adult allogeneic HCT recipients.Twenty-seven patients developed clinically actionable phenotype of TMA (CA-TMA) and the incidence of CA-TMA was 22% by day 180. Among the 27 patients that developed CA-TMA, 10 patients developed CA-TMA prior to onset of acute graft-versus-host disease (aGVHD) and 17 patients developed CA-TMA after the onset of aGVHD. We report for the first time that age > 50, BK hemorrhagic cystitis) and other viral infections (CMV, HHV-6, Adenovirus) are risk factors for adult CA-TMA. Even after adjusting for aGVHD, CA-TMA was independently associated with significantly higher non-relapse mortality.These data illustrate relationships between CA-TMA and aGVHD, describe new risk factors for CA-TMA and emphasizes theneed to develop validated set of criteria for timely diagnosis. |
| Databáze: |
Supplemental Index |
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