Journal
BONE MARROW TRANSPLANTATION
Volume 30, Issue 11, Pages 709-715Publisher
NATURE PUBLISHING GROUP
DOI: 10.1038/sj.bmt.1703710
Keywords
bone marrow transplantation; thrombotic thrombocytopenic purpura; endothelium; treatment; tumor necrosis factor alpha
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A syndrome of microangiopathic hemolytic anemia, renal dysfunction and neurological abnormalities was first noted in bone marrow transplant recipients 22 years ago. Now known as transplantation-associated thrombotic microangiopathy (TA-TMA) to distinguish it from other thrombotic microangiopathies, this disorder responds poorly to conventional treatments for thrombotic thrombocytopenic purpura. In this review, we discuss the incidence and risk factors for TA-TMA and describe a pathophysiologic model of the disorder based on results obtained from laboratory models of the thrombotic microangiopathies. We conclude by suggesting possible approaches to the early diagnosis and treatment of TA-TMA based on this model that may warrant testing in future clinical trials.
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