دورية أكاديمية
أعرض في EDS

Epidemiology and outcomes of pediatric transplant-associated thrombotic microangiopathy in Hong Kong.

التفاصيل البيبلوغرافية
العنوان: Epidemiology and outcomes of pediatric transplant-associated thrombotic microangiopathy in Hong Kong.
المؤلفون: Chan WYK; Paediatric Hematology, Oncology and Hematopoietic Stem Cell Transplantation Team, Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong Special Administrative Region, China., Ma ALT; Pediatric Nephrology team, Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong Special Administrative Region, China., Chan EYH; Pediatric Nephrology team, Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong Special Administrative Region, China., Kan ANC; Department of Pathology, Hong Kong Children's Hospital, Hong Kong Special Administrative Region, China., Ng WF; Department of Pathology, Hong Kong Children's Hospital, Hong Kong Special Administrative Region, China., Lee PPW; Paediatric Hematology, Oncology and Hematopoietic Stem Cell Transplantation Team, Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong Special Administrative Region, China., Cheuk DKL; Paediatric Hematology, Oncology and Hematopoietic Stem Cell Transplantation Team, Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong Special Administrative Region, China., Chiang AKS; Paediatric Hematology, Oncology and Hematopoietic Stem Cell Transplantation Team, Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong Special Administrative Region, China., Leung W; Paediatric Hematology, Oncology and Hematopoietic Stem Cell Transplantation Team, Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong Special Administrative Region, China., Chan GCF; Paediatric Hematology, Oncology and Hematopoietic Stem Cell Transplantation Team, Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Hong Kong Special Administrative Region, China.
المصدر: Pediatric transplantation [Pediatr Transplant] 2022 Nov; Vol. 26 (7), pp. e14366. Date of Electronic Publication: 2022 Jul 21.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: Munksgaard Country of Publication: Denmark NLM ID: 9802574 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1399-3046 (Electronic) Linking ISSN: 13973142 NLM ISO Abbreviation: Pediatr Transplant Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Copenhagen ; Malden, MA : Munksgaard, c1997-
مواضيع طبية MeSH: Cyclosporins* , Hematopoietic Stem Cell Transplantation*/adverse effects , Renal Insufficiency, Chronic*/etiology , Thrombotic Microangiopathies*/diagnosis , Thrombotic Microangiopathies*/epidemiology , Thrombotic Microangiopathies*/etiology, Aged ; Child ; Female ; Hong Kong/epidemiology ; Humans ; Male
مستخلص: Background: Transplant-associated thrombotic microangiopathy (TA-TMA) is an under-recognized yet potentially devastating complication of hematopoietic stem cell transplantation (HSCT) which had increased awareness in recent years. This report summarizes the demographics and outcomes of pediatric TA-TMA in Hong Kong.
Methods: All patients aged below 18 years who underwent HSCT in the Hong Kong Children's Hospital and were diagnosed to have TA-TMA during the 2-year period from April 1, 2019 to March 31, 2021 were included.
Results: A total of 73 transplants (51 allogeneic and 22 autologous) in 63 patients had been performed. Six patients (four males and two females) developed TA-TMA at a median duration of 2.5 months post-HSCT. The incidence rate was 9.52%. Of the six TA-TMA patients, five underwent allogenic one underwent autologous HSCT, respectively. Three of them were histologically proven. All four patients with cyclosporine had stopped the drug once TA-TMA was suspected. Median six doses of eculizumab were administered to five out of six patients. Three patients died (two due to fungal infection and one due to acute-on-chronic renal failure) within 3 months upon diagnosis of TA-TMA. Among three survivors, two stabilized with mild stage 2 chronic kidney disease (CKD) while the other suffered from stage 5 end-stage CKD requiring lifelong dialysis.
Conclusion: In conclusion, recognition and diagnosis of TA-TMA are challenging. Early recognition and prompt administration of complement blockage with eculizumab may be beneficial in selected cases. Further prospective research studies are recommended to improve the management and outcomes of TA-TMA.
(© 2022 Wiley Periodicals LLC.)
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فهرسة مساهمة: Keywords: Hong Kong; hematopoietic stem cell transplantation; morbidity; thrombotic microangiopathy
المشرفين على المادة: 0 (Cyclosporins)
تواريخ الأحداث: Date Created: 20220721 Date Completed: 20221012 Latest Revision: 20221028
رمز التحديث: 20240628
DOI: 10.1111/petr.14366
PMID: 35860972
قاعدة البيانات: MEDLINE
الوصف
تدمد:1399-3046
DOI:10.1111/petr.14366