A new paradigm: Diagnosis and management of HSCT-associated thrombotic
microangiopathy as multi-system endothelial injury
#MMPMID25483393
Jodele S
; Laskin BL
; Dandoy CE
; Myers KC
; El-Bietar J
; Davies SM
; Goebel J
; Dixon BP
Blood Rev
2015[May]; 29
(3
): 191-204
PMID25483393
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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.
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