Risk factors for transplant-associated thrombotic microangiopathy and mortality in a pediatric cohort.

Blood Advances
Michelle SchoettlerChristine Duncan

Abstract

Transplant-associated thrombotic microangiopathy (TA-TMA) is a well-recognized complication of hematopoietic cell transplantation (HCT). Diagnosis is challenging and in the absence of a tissue biopsy, TA-TMA is provisionally diagnosed by meeting clinical criteria. In this study, we describe the prevalence, outcomes, and risk factors for meeting 2 different diagnostic criteria for TA-TMA and for increased transplant-related mortality (TRM). In this retrospective study of 307 pediatric HCT patients, records were reviewed for the first 100 days after HCT. Patients who were diagnosed with TA-TMA by a provider during this time were included. In addition, the Cho et al criteria (2010) and Jodele et al (2014) TA-TMA criteria were applied retrospectively. Eight patients (2.6%) were diagnosed with TA-TMA by their provider. However, on retrospective review, 20% and 36% met the Cho and Jodele criteria for TA-TMA, respectively. Overall survival was significantly worse (P < .0001) and TRM was significantly higher in patients who met criteria for TA-TMA (MC-TA-TMA) (P < .0001). After controlling for comorbid conditions, MC-TA-TMA (hazard ratio [HR], 10.9; P = .0001) and grade 3/4 acute graft-versus-host-disease (aGVHD) (HR 3.5; P = .01) rema...Continue Reading

References

Aug 31, 2002·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Andrew S DalyThomas L Kiss
Jul 26, 2005·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Vincent T HoSergio Giralt
Jan 14, 2009·Bone Marrow Transplantation·Y InamotoUNKNOWN Nagoya Blood and Marrow Transplantation Group
Nov 10, 2009·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Andrea BacigalupoMary Horowitz
Oct 20, 2012·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Sepideh ShayaniRyotaro Nakamura
Dec 29, 2013·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Sonata JodeleStella M Davies
Aug 12, 2015·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Prajwal DhakalVijaya Raj Bhatt
Oct 13, 2015·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Sonata JodeleStella M Davies
Feb 6, 2016·Journal of Cardiothoracic and Vascular Anesthesia·Kianoush Kashani, Daryl J Kor
May 10, 2016·Transfusion and Apheresis Science : Official Journal of the World Apheresis Association : Official Journal of the European Society for Haemapheresis·Sonata JodeleBenjamin L Laskin
May 15, 2018·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Merve PostalciogluReza Abdi
Jan 15, 2019·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Michelle SchoettlerChristine Duncan

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Citations

Mar 4, 2021·Journal of the American Society of Nephrology : JASN·Daniel M GreenMelissa M Hudson
Jun 3, 2021·Journal of Personalized Medicine·Archana RamgopalRamasubramanian Kalpatthi
Sep 18, 2021·Current Opinion in Hematology·Michelle SchoettlerLeslie Lehmann

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