Complement in Pathophysiology and Treatment of Transplant-Associated Thrombotic Microangiopathies

Seminars in Hematology
Sonata Jodele

Abstract

Transplant-associated thrombotic microangiopathy (TA-TMA) is a form of microangiopathy specifically occurring in the context of hematopoietic stem cell transplantation. Similarly, to other microangiopathies, TA-TMA is characterized by hemolytic anemia, thrombocytopenia, and organ failure due to endothelial injury. Although its clinical association with medications (eg, calcineurin inhibitors), immune reactions (eg, graft vs host disease) or infectious complications is well established, the pathophysiology remains largely unknown. Recent data have highlighted the role of complement in the pathophysiology of TA-TMA, which are frequently associated with a functional impairment (either inherited or acquired) of the endogenous regulation of the complement classic and alternative pathway. This manuscript will review the data supporting the involvement of complement in the pathophysiology of TA-TMA, as well as the clinical data supporting the use of anticomplement agents in this rare condition.

Citations

Jul 14, 2020·Blood Advances·Hiroyuki MatsuiUNKNOWN Kyoto Stem Cell Transplantation Group (KSCTG)
Jul 22, 2019·Nature Reviews. Drug Discovery·Dimitrios C MastellosJohn D Lambris
Mar 26, 2020·Blood Advances·Sonata JodeleStella M Davies
Oct 6, 2020·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Jacopo MariottiLuca Castagna
Oct 16, 2020·Annals of the American Thoracic Society·Robert F TamburroUNKNOWN Pulmonary Complications of Pediatric Hematopoietic Stem Cell Transplantation Workshop Participants
Mar 11, 2021·Journal of Nephrology·Momin H AlkhatibMohamed G Atta
Apr 17, 2021·Translational Oncology·Patrícia ValérioJosé Maximino Costa
May 22, 2021·Pediatric Blood & Cancer·Anthony SabulskiSonata Jodele
Jul 14, 2021·Bone Marrow Transplantation·Thomas LuftAleksandar Radujkovic
Sep 23, 2020·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Philip H ImusRichard J Jones

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