Risk factors for thrombotic microangiopathy in allogeneic hematopoietic stem cell recipients receiving GVHD prophylaxis with tacrolimus plus MTX or sirolimus
| Autor: | M.C. del Cañizo, Jorge Labrador, Lucía López-Corral, Oriana López-Godino, Raúl Pérez-López, Ignacio Alberca, Dolores Caballero, Fermín Sánchez-Guijo, Carmen Guerrero, Estefania Perez-Lopez, José Ramón González-Porras, María Díez-Campelo, José A. Pérez-Simón, Lourdes Vázquez, M Cabrero-Calvo |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male medicine.medical_specialty Thrombotic microangiopathy Graft vs Host Disease chemical and pharmacologic phenomena Gastroenterology Tacrolimus Young Adult immune system diseases Risk Factors Internal medicine hemic and lymphatic diseases medicine Humans Transplantation Homologous Aged Retrospective Studies Sirolimus Transplantation business.industry Thrombotic Microangiopathies Incidence (epidemiology) Incidence Transplant-associated thrombotic microangiopathy Hematopoietic Stem Cell Transplantation Hematology Middle Aged medicine.disease Prognosis Calcineurin stomatognathic diseases Graft-versus-host disease surgical procedures operative Methotrexate Risk factors Allo-SCT Immunology Multivariate Analysis Drug Therapy Combination Female Complication business Immunosuppressive Agents medicine.drug |
| Zdroj: | Digital.CSIC. Repositorio Institucional del CSIC instname |
| ISSN: | 1476-5365 |
| Popis: | Post-transplant complications.-- et al. Transplantation-associated thrombotic microangiopathy (TA-TMA) is a feared complication of allogeneic hematopoietic SCT (HSCT) owing to its high mortality rate. The use of calcineurin inhibitors or sirolimus (SIR) for GVHD prophylaxis has been suggested as a potential risk factor. However, the impact of tacrolimus (TAC) and SIR combinations on the increased risk of TA-TMA is currently not well defined. We retrospectively analyzed the incidence of TA-TMA in 102 allogeneic HSCT recipients who consecutively received TAC plus SIR (TAC/SIR) (n=68) or plus MTX (TAC/MTX)±ATG (n=34) for GVHD prophylaxis. No significant differences were observed in the incidence of TA-TMA between patients receiving TAC/SIR vs TAC/MTX±ATG (7.4% vs 8.8%, P=0.8). Only grade III-IV acute GVHD, previous HSCT and serum levels of TAC >25 ng/mL were associated with a greater risk of TA-TMA. Patients developing TA-TMA have significantly poorer survival (P |
| Databáze: | OpenAIRE |
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