当前位置： SCI文献检索 > BONE MARROW TRANSPLANTATION期刊下所有文献 > Risk factors for thrombotic microangiopathy in allogeneic hematopoietic stem cell recipients receiving GVHD prophylaxis with tacrolimus plus MTX or sirolimus.

Risk factors for thrombotic microangiopathy in allogeneic hematopoietic stem cell recipients receiving GVHD prophylaxis with tacrolimus plus MTX or sirolimus.

Abstract：

:Transplantation-associated thrombotic microangiopathy (TA-TMA) is a feared complication of allogeneic hematopoietic SCT (HSCT) owing to its high mortality rate. The use of calcineurin inhibitors or sirolimus (SIR) for GVHD prophylaxis has been suggested as a potential risk factor. However, the impact of tacrolimus (TAC) and SIR combinations on the increased risk of TA-TMA is currently not well defined. We retrospectively analyzed the incidence of TA-TMA in 102 allogeneic HSCT recipients who consecutively received TAC plus SIR (TAC/SIR) (n=68) or plus MTX (TAC/MTX)±ATG (n=34) for GVHD prophylaxis. No significant differences were observed in the incidence of TA-TMA between patients receiving TAC/SIR vs TAC/MTX±ATG (7.4% vs 8.8%, P=0.8). Only grade III-IV acute GVHD, previous HSCT and serum levels of TAC >25 ng/mL were associated with a greater risk of TA-TMA. Patients developing TA-TMA have significantly poorer survival (P<0.001); however, TA-TMA ceased to be an independent prognostic factor when it was included in a multivariate model. In conclusion, the combination of TAC/SIR does not appear to pose a higher risk of TA-TMA. By contrast, we identified three different risk groups for developing TA-TMA.

journal_name

Bone Marrow Transplant

journal_title

Bone marrow transplantation

authors

Labrador J,López-Corral L,López-Godino O,Vázquez L,Cabrero-Calvo M,Pérez-López R,Díez-Campelo M,Sánchez-Guijo F,Pérez-López E,Guerrero C,Alberca I,Del Cañizo MC,Pérez-Simón JA,González-Porras JR,Caballero D

doi

10.1038/bmt.2014.17

subject

Has Abstract

pub_date

2014-05-01 00:00:00

pages

684-90

issue

5

eissn

0268-3369

issn

1476-5365

pii

bmt201417

journal_volume

49

pub_type

杂志文章

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