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المؤلفون: Luis F. Porrata, Morie A. Gertz, Suzanne R. Hayman, David J. Inwards, Dong Chen, Cihan Heybeli, Francis K. Buadi, Saad S. Kenderian, Mark R. Litzow, David Dingli, Nelson Leung, Hassan B. Alkhateeb, Mithun Vinod Shah, Shaji Kumar, Shahrukh K. Hashmi, Meera Sridharan, Ronald S. Go, Martha Q. Lacy, Ivana N. Micallef, Mrinal M. Patnaik, William J. Hogan, Angela Dispenzieri, Jose Villasboas Bisneto
المصدر: American journal of hematologyREFERENCES.
مصطلحات موضوعية: medicine.medical_specialty, Thrombotic microangiopathy, business.industry, medicine.medical_treatment, Mortality rate, Hematology, Hematopoietic stem cell transplantation, medicine.disease, Lower risk, Gastroenterology, Transplantation, 03 medical and health sciences, 0302 clinical medicine, immune system diseases, Negatively associated, 030220 oncology & carcinogenesis, Internal medicine, Cohort, medicine, In patient, business, 030215 immunology
الوصف: Transplant-associated thrombotic microangiopathy (TA-TMA) has a wide range of presentations after hematopoietic stem-cell transplantation (HSCT). We retrospectively studied the risk factors and outcomes of patients with early (≤day 100) and late (>day 100) TA-TMA. Among the 1451 HSCT recipients, early TA-TMA occurred in 45 (3.1%) patients at a median of 27 (3-91) days, and late TA-TMA in 39 (2.7%) patients at a median of 303 (122-2595) days. Patients with early TA-TMA were more likely to have high blood calcineurin-inhibitor levels (P < .001) and acute graph-vs-host disease (GVHD, P < .001), while late TMA patients were more likely to have chronic GVHD (P < .001). The estimated median overall survival after onset of TMA for the entire cohort was 6 months. The estimated median overall survival was not reached in patients with an improvement of TMA vs 2 months in patients with no improvement (P < .001). In the early TMA group, older age (for every 10 years, HR 1.40; 95% CI 1.00-1.94; P = .049) and bacterial infection (HR 2.42; 95% CI 0.98-6.00; P = .056) were positively associated with mortality. Switching to MMF treatment (HR 0.40; 95% CI 0.16-0.99; P = .047) and improvement of TMA (HR 0.08; 95% CI 0.03-0.25; P < .001) were negatively associated with mortality in the multivariate analysis. In the late TMA group, the improvement of TMA was the only independent predictor associated with a lower risk of death (HR 0.05; 95% CI 0.02-0.19; P < .001). Mortality rates in both early and late TMA remain unacceptably high. Future studies are needed for early diagnosis, trigger identifications, and use of targeted treatments.
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ef64abe9d7a87822d3b8f6431b439906Test
https://pubmed.ncbi.nlm.nih.gov/32618000Test -
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المؤلفون: Timothy G. Call, Neil E. Kay, Esteban Braggio, Eli Muchtar, Sameer A. Parikh, Susan M. Schwager, Thomas E. Witzig, Jose F. Leis, Kari G. Rabe, Daniel L. Van Dyke, Amie Fonder, Saad S. Kenderian, Wei Ding, Paul J. Hampel, Yucai Wang, Amber B. Koehler, Susan L. Slager
المصدر: American journal of hematologyREFERENCES. 95(3)
مصطلحات موضوعية: Oncology, Male, medicine.medical_specialty, Disease free survival, Combination therapy, Chronic lymphocytic leukemia, Disease-Free Survival, chemistry.chemical_compound, Bridged Bicyclo Compounds, Piperidines, Internal medicine, medicine, Humans, Survival rate, Aged, Aged, 80 and over, Sulfonamides, Venetoclax, business.industry, Adenine, Hematology, Middle Aged, medicine.disease, Bridged Bicyclo Compounds, Heterocyclic, Leukemia, Lymphocytic, Chronic, B-Cell, Survival Rate, Leukemia, Pyrimidines, chemistry, Ibrutinib, Pyrazoles, Female, business
الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e311febaff680b596fa31d7a21ff2964Test
https://pubmed.ncbi.nlm.nih.gov/31788844Test