Thrombotic microangiopathy in allogeneic stem cell transplantation in childhood

Exp Clin Transplant. 2010 Sep;8(3):237-44.

Abstract

Objectives: We define the incidence, risk factors, and mortality rates for the occurrence of thrombotic microangiopathy in 50 children who underwent transplants between January 2006 and June 2008 at 2 Turkish pediatric centers.

Materials and methods: The diagnosis of thrombotic microangiopathy was done according to the reports of International Working Group in 2007.

Results: Fifty patients (27 male and 23 female; age range, 3 months to 18 years) were included. Patients with malignant and nonmalignant diseases were 13 (26%) and 37 (74%). Myeloablative and nonmyeloablative conditioning regimens were used in 29 (58%) and 21 patients (42%). Bone marrow was used as the source of stem cells in 32 patients (62%) and peripheral blood was used in 18 patients (36%). Thrombotic microangiopathy was seen in 3 of 50 cases (6%). Thrombotic microangiopathy developed in 3 of 18 patients in whom peripheral blood was used as the source of stem cells while none of 32 patients who had bone marrow as the source developed thrombotic microangiopathy (P < .05).

Conclusions: Using peripheral blood as a source of stem cells is a risk factor for development of thrombotic microangiopathy.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Bone Marrow Transplantation / adverse effects*
  • Bone Marrow Transplantation / mortality
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Incidence
  • Infant
  • Kaplan-Meier Estimate
  • Male
  • Peripheral Blood Stem Cell Transplantation / adverse effects*
  • Peripheral Blood Stem Cell Transplantation / mortality
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Survival Rate
  • Thrombotic Microangiopathies / diagnosis
  • Thrombotic Microangiopathies / etiology*
  • Thrombotic Microangiopathies / mortality
  • Time Factors
  • Transplantation, Homologous
  • Treatment Outcome
  • Turkey / epidemiology