Diagnosis and treatment of transplantation-associated thrombotic microangiopathy: real progress or are we still waiting?
Top Cited Papers
- 2 July 2007
- journal article
- review article
- Published by Springer Science and Business Media LLC in Bone Marrow Transplantation
- Vol. 40 (8), 709-719
- https://doi.org/10.1038/sj.bmt.1705758
Abstract
Transplantation-associated thrombotic microangiopathy (TA-TMA) is an infrequent but devastating syndrome that occurs in allogeneic hematopoietic stem cell transplant recipients, and is associated with a variety of transplantation-related factors, including conditioning regimens, immunosuppressive agents, GVHD and opportunistic infections. Progress in managing this condition has been hampered by lack of a consensus definition and poor understanding of the pathophysiology of the disorder. Two different groups recently have proposed consensus definitions, yet they fail to distinguish the primary syndrome from the secondary causes, such as a variety of infections, medication exposure or other conditions. Increasing evidence suggests that TA-TMA is a multifactorial disorder that is distinct from thrombotic thrombocytopenic purpura (TTP), and likely represents the final common pathway of a number of endothelial cell insults. TA-TMA responds poorly to conventional treatment for TTP, including plasma exchange, but newer agents, including daclizumab and defibrotide show promise. In addition, other agents known to modify endothelial responses to injury, including statins, prostacyclin analogues, endothelin-receptor antagonists and free radical scavengers, may lead to improved outcomes for patients affected by this disorder.Keywords
This publication has 109 references indexed in Scilit:
- Protection From Procedural Myocardial Injury by Atorvastatin Is Associated With Lower Levels of Adhesion Molecules After Percutaneous Coronary Intervention: Results From the ARMYDA-CAMs (Atorvastatin for Reduction of MYocardial Damage during Angioplasty-Cell Adhesion Molecules) SubstudyJournal of the American College of Cardiology, 2006
- Genetics of HUS: the impact of MCP, CFH, and IF mutations on clinical presentation, response to treatment, and outcomeBlood, 2006
- Circulating Endothelial Cells, Endothelial Progenitor Cells, and Endothelial Microparticles in CancerNeoplasia, 2006
- Thrombotic Microangiopathy in Transplantation and MalignancySeminars in Thrombosis and Hemostasis, 2005
- Severe thrombotic microangiopathy: an infrequent complication of bone marrow transplantationBone Marrow Transplantation, 1999
- Thrombotic microangiopathy following allogeneic bone marrow transplantation is associated with intensive graft-versus-host disease prophylaxisBone Marrow Transplantation, 1998
- Defibrotide Protects Endothelial Cells, but not L929 Tumour Cells, from Tumour Necrosis Factor-α-mediated CytotoxicityJournal of Pharmacy and Pharmacology, 1995
- THE ACUTE EFFECT OF FK506 AND CYCLOSPORINE ON ENDOTHELIAL CELL FUNCTION AND RENAL VASCULAR RESISTANCETransplantation, 1992
- Nephrotoxicity of Cyclosporin a after Allogeneic Marrow TransplantationThe New England Journal of Medicine, 1981
- CYCLOSPORIN A TO PREVENT GRAFT-VERSUS-HOST DISEASE IN MAN AFTER ALLOGENEIC BONE-MARROW TRANSPLANTATIONThe Lancet, 1980