Document Detail


Thrombotic microangiopathy following bone marrow transplantation.
MedLine Citation:
PMID:  7858524     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Thrombotic microangiopathy (TMA) is a well-recognised disorder which may occur in up to 6% of patients following bone marrow transplantation (BMT). Reported cases of post-BMT TMA vary widely in their reported clinical features, severity and response to therapy. Several factors are important in the aetiology, including cyclosporin A (CsA), graft-versus-host disease, irradiation, intensive conditioning chemotherapy and infection. A unifying pathogenetic mechanism is suggested, wherein these factors may interact to produce post-BMT TMA. On the basis of differences in clinical features and prognosis, we propose the classification of post-BMT TMA into four distinctive although overlapping subtypes: multifactorial fulminant TMA, conditioning-associated haemolytic-uraemic syndrome, CsA-associated nephrotoxicity with microangiopathic haemolytic anaemia (MAHA) and CsA-associated neurotoxicity with MAHA. Treatment of post-BMT TMA, especially of the poor-prognosis multifactorial fulminant subtype, is currently unsatisfactory, although occasional cases may respond to plasma exchange.
Authors:
A R Pettitt; R E Clark
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Bone marrow transplantation     Volume:  14     ISSN:  0268-3369     ISO Abbreviation:  Bone Marrow Transplant.     Publication Date:  1994 Oct 
Date Detail:
Created Date:  1995-03-23     Completed Date:  1995-03-23     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  8702459     Medline TA:  Bone Marrow Transplant     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  495-504     Citation Subset:  IM    
Affiliation:
Department of Haematology, Royal Liverpool University Hospital, UK.
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MeSH Terms
Descriptor/Qualifier:
Anemia, Hemolytic / etiology*
Bone Marrow Transplantation / adverse effects*
Cyclosporine / adverse effects
Endothelium, Vascular / drug effects
Graft vs Host Disease / complications
Hemolytic-Uremic Syndrome / etiology*
Humans
Purpura, Thrombotic Thrombocytopenic / etiology*
Chemical
Reg. No./Substance:
59865-13-3/Cyclosporine
Comments/Corrections
Comment In:
Bone Marrow Transplant. 1996 May;17(5):897-8   [PMID:  8733719 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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