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Serum neutrophil extracellular trap levels predict thrombotic microangiopathy after allogeneic stem cell transplantation
- Source :
- Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation. 19(12)
- Publication Year :
- 2013
-
Abstract
- Transplantation-associated thrombotic microangiopathy (TA-TMA) is a devastating complication of hematopoietic stem cell transplantation. TA-TMA likely represents the final stage of vascular endothelial injury; however, its pathophysiology is largely unknown, making clinical management difficult. Recently, the association of neutrophil extracellular traps (NETs) with the development of thrombotic thrombocytopenic purpura and hemolytic uremic syndrome has been reported. Thus, we explored whether NETs are also relevant to the occurrence of TA-TMA. We retrospectively analyzed post-transplant trends of serum NET levels in 90 patients, 11 of whom developed TA-TMA. Relative to baseline (before the conditioning regimen), elevated serum NET levels either at 4 weeks after transplantation or as early as the day of transplantation were associated with significantly increased risk of TA-TMA. In contrast, thrombomodulin, a potential marker for TA-TMA, was not helpful to predict the occurrence of TA-TMA in our study. In addition, we directly detected glomerular deposition of NETs in 2 TA-TMA patients. Increased NET levels are a significant risk factor for TA-TMA, suggesting that NET level is a useful biomarker for TA-TMA.
- Subjects :
- Adult
Male
Thrombotic microangiopathy
Transplantation Conditioning
Adolescent
Neutrophils
medicine.medical_treatment
Thrombotic thrombocytopenic purpura
Hematopoietic stem cell transplantation
urologic and male genital diseases
Thrombomodulin
Neutrophil extracellular traps
Transplantation, Autologous
Young Adult
immune system diseases
Predictive Value of Tests
hemic and lymphatic diseases
Medicine
Humans
neoplasms
Aged
Retrospective Studies
Transplantation
business.industry
Thrombotic Microangiopathies
Hematopoietic Stem Cell Transplantation
Hematology
Middle Aged
medicine.disease
female genital diseases and pregnancy complications
Allogeneic stem cell transplantation
Predictive biomarker
Treatment Outcome
Immunology
Biomarker (medicine)
Female
Stem cell
business
Subjects
Details
- ISSN :
- 15236536
- Volume :
- 19
- Issue :
- 12
- Database :
- OpenAIRE
- Journal :
- Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation
- Accession number :
- edsair.doi.dedup.....8636b8a452ec9bf9be9ef5160e4bedc9