ABO-incompatible allogeneic hematopoietic stem cell transplantation following reduced-intensity conditioning: close association with transplant-associated microangiopathy.
Transplant-associated microangiopathy (TAM) is a severe complication following allogeneic hematopoietic stem cell transplantation (HSCT) even after reduced-intensity conditioning (RIC). Data on 112 patients following RIC were analyzed with respect to TAM according to the ASBMT and risk factors, response to well-defined therapy and outcome were determined. TAM occurred in 11 of 112 patients. Univariate analysis determined acute graft-versus-host disease and ABO-incompatibility as risk factors for TAM. Treatment consisted of withdrawal of calcineurin inhibitors and plasma exchange (PE). Response to PE was 64%. PE seems to be an effective therapeutic option that should be assessed in larger patient cohorts.
Worel
Nina
N
Department of Blood Group Serology and Transfusion Medicine, Bone Marrow Transplantation, Medical University of Vienna, Waehringer, Guertel 18 - 20, A-1090 Vienna, Austria. nina.worel@meduniwien.ac.at
Greinix
Hildegard T
HT
Leitner
Gerda
G
Mitterbauer
Margit
M
Rabitsch
Werner
W
Rosenmayr
Agatha
A
Höcker
Paul
P
Kalhs
Peter
P
D000017:ABO Blood-Group System / Q000276:immunology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001787:Blood Group Incompatibility / Q000150:complications*; D005260:Female; D006086:Graft vs Host Disease; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008833:Microcirculation; D055806:Microvessels / Q000473:pathology; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000209:etiology* / Q000628:therapy; D010951:Plasma Exchange; D012307:Risk Factors; D019172:Transplantation Conditioning / Q000379:methods*; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D055815:Young Adult
D000017:ABO Blood-Group System