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Intestinal thrombotic microangiopathy following reduced-intensity umbilical cord blood transplantation.
- Source :
-
Bone Marrow Transplantation . Sep2005, Vol. 36 Issue 6, p517-523. 7p. - Publication Year :
- 2005
-
Abstract
- Summary:Thrombotic microangiopathy (TMA) is a significant complication after hematopoietic stem-cell transplantation (HSCT); however, there is little information on it following reduced-intensity cord blood transplantation (RI-CBT). We reviewed the medical records of 123 adult patients who received RI-CBT at Toranomon Hospital between January 2002 and August 2004. TMA was diagnosed in seven patients based on intestinal biopsy (n=6) or autopsy results (n=1). While these patients showed some clinical symptoms such as diarrhea and/or abdominal pain, mental status alterations or neurological disorders were not observed in any of them. Laboratory results were mostly normal at the onset of TMA; >2% fragmented erythrocytes (n=1), <10 mg/dl haptoglobin (n=1), and >200 IU/dl lactic dehydrogenase (LD) (n=4). On endoscopic examination, TMA lesions, consisting of ulcers, erosions, and diffuse exfoliation, were distributed spottily from terminal ileum to rectum. Intestinal graft-versus-host disease (GVHD) and cytomegalovirus (CMV) colitis were confirmed in five and four patients, respectively. With therapeutic measures including supportive care (n=4), fresh frozen plasma (n=1), and a reduction of immunosuppressive agents (n=1), TMA improved in four patients. The present study demonstrates that intestinal TMA is a significant complication after RI-CBT. Since conventional diagnostic criteria can overlook TMA, its diagnosis requires careful examination of the gastrointestinal tract using endoscopy with biopsy.Bone Marrow Transplantation (2005) 36, 517–523. doi:10.1038/sj.bmt.1705099; published online 18 July 2005 [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 02683369
- Volume :
- 36
- Issue :
- 6
- Database :
- Academic Search Index
- Journal :
- Bone Marrow Transplantation
- Publication Type :
- Academic Journal
- Accession number :
- 18128404
- Full Text :
- https://doi.org/10.1038/sj.bmt.1705099