Emerging Concepts in Hematopoietic Stem Cell Transplantation-Associated Renal Thrombotic Microangiopathy and Prospects for New Treatments

American Journal of Kidney Diseases : the Official Journal of the National Kidney Foundation
Rimda WanchooKenar D Jhaveri

Abstract

Thrombotic microangiopathy associated with hematopoietic stem cell transplantation (HSCT-TMA) is a well-recognized complication of HSCT that has a high risk for death. Even in patients who survive, HSCT-TMA is associated with long-term morbidity and chronic organ injury. HSCT-TMA is a multisystem disease that often affects the kidneys. Renal manifestations of HSCT-TMA include reduced glomerular filtration rate, proteinuria, and hypertension. Understanding of the pathophysiology of HSCT-TMA has expanded in the last decade. Endothelial injury plays a major role. Recent studies also suggest involvement of complement activation. HSCT-TMA has also been considered by some to be an endothelial variant of graft-versus-host disease. Understanding the pathophysiology of HSCT-TMA and its association with activation of the complement system may aid in developing novel therapeutic options. In this review, we summarize current knowledge focusing on epidemiology and prognosis, evidence of complement activation, and endothelial injury; the possible link to graft-versus-host disease; and treatment options for HSCT-TMA.

Citations

Sep 17, 2019·Current Opinion in Critical Care·Rimda WanchooKenar D Jhaveri
Aug 28, 2020·CA: a Cancer Journal for Clinicians·Mitchell H RosnerMark A Perazella
Dec 15, 2019·Clinical Journal of the American Society of Nephrology : CJASN·Amanda DeMauro RenaghanMitchell Howard Rosner
Nov 25, 2020·Journal of Clinical Medicine·Epameinondas KoumpisGeorge Liamis
Mar 2, 2021·Frontiers in Immunology·Jacob J E KoopmanCees van Kooten
Apr 17, 2021·Translational Oncology·Patrícia ValérioJosé Maximino Costa
Sep 10, 2021·Clinical Journal of the American Society of Nephrology : CJASN·Benjamin ThoreauJean-Michel Halimi

❮ Previous
Next ❯

Related Concepts

Related Feeds

Allogenic & Autologous Therapies

Allogenic therapies are generated in large batches from unrelated donor tissues such as bone marrow. In contrast, autologous therapies are manufactures as a single lot from the patient being treated. Here is the latest research on allogenic and autologous therapies.

Blood And Marrow Transplantation

The use of hematopoietic stem cell transplantation or blood and marrow transplantation (bmt) is on the increase worldwide. BMT is used to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Here is the latest research on bone and marrow transplantation.