A New Paradigm: Diagnosis and Management of HSCT-associated Thrombotic Microangiopathy As Multi-system Endothelial Injury

Overview

Journal Blood Rev

Publisher Elsevier

Specialty Hematology

Date 2014 Dec 9

PMID 25483393

Citations 124

Authors

Sonata Jodele

Benjamin L Laskin

Christopher E Dandoy

Kasiani C Myers

Javier El-Bietar

Stella M Davies

Jens Goebel

Bradley P Dixon

Affiliations

Soon will be listed here.

Abstract

Hematopoietic stem cell transplantation (HSCT)-associated thrombotic microangiopathy (TA-TMA) is now a well-recognized and potentially severe complication of HSCT that carries a high risk of death. In those who survive, TA-TMA may be associated with long-term morbidity and chronic organ injury. Recently, there have been new insights into the incidence, pathophysiology, and management of TA-TMA. Specifically, TA-TMA can manifest as a multi-system disease occurring after various triggers of small vessel endothelial injury, leading to subsequent tissue damage in different organs. While the kidney is most commonly affected, TA-TMA involving organs such as the lung, bowel, heart, and brain is now known to have specific clinical presentations. We now review the most up-to-date research on TA-TMA, focusing on the pathogenesis of endothelial injury, the diagnosis of TA-TMA affecting the kidney and other organs, and new clinical approaches to the management of this complication after HSCT.

Citing Articles

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