論文

査読有り
2016年4月

Treatment of thrombotic microangiopathy after hematopoietic stem cell transplantation with recombinant human soluble thrombomodulin

TRANSFUSION
  • Hideaki Fujiwara
  • ,
  • Yoshinobu Maeda
  • ,
  • Yasuhisa Sando
  • ,
  • Makoto Nakamura
  • ,
  • Katsuma Tani
  • ,
  • Tatsunori Ishikawa
  • ,
  • Hisakazu Nishimori
  • ,
  • Ken-Ichi Matsuoka
  • ,
  • Nobuharu Fujii
  • ,
  • Eisei Kondo
  • ,
  • Mitsune Tanimoto

56
4
開始ページ
886
終了ページ
892
記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1111/trf.13437
出版者・発行元
WILEY

BACKGROUNDTransplant-associated thrombotic microangiopathy (TA-TMA) after hematopoietic stem cell transplantation (HSCT) remains a severe complication associated with underlying endothelial damage. TMA has a high mortality rate with no definite treatments and effective treatments are needed.
STUDY DESIGN AND METHODSThe study objective was to retrospectively analyze the outcome of patients receiving recombinant human soluble thrombomodulin (rTM), which has cytoprotective effects against calcineurin inhibitor-induced endothelial cell damage, or other therapeutics for TA-TMA from 254 consecutive HSCT recipients between 2009 to 2014 at a single institution. We hypothesized that patients receiving rTM as a first-line treatment would receive a benefit.
RESULTSSixteen patients were diagnosed as TA-TMA. Of these 16 patients, nine were treated with rTM (rTM group), and seven received treatment other than rTM (control group) as a first-line therapy. Seven of the nine patients in the rTM group recovered from TA-TMA without complications, but none in the control group recovered. The rTM group showed a significantly better overall survival after TA-TMA onset than did the control group (median, 123.0 days vs. 45.5 days, respectively; p=0.045). The cumulative incidence of acute graft-versus-host disease was the same in both groups (56% vs. 57%, respectively; p=0.52) on Day 100 after TA-TMA onset.
CONCLUSIONThis is the first report evaluating rTM administration for TA-TMA compared with previous treatments. Our data suggests that rTM might offer a better clinical outcome in patients with TA-TMA.

Web of Science ® 被引用回数 : 16

リンク情報
DOI
https://doi.org/10.1111/trf.13437
Web of Science
https://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=JSTA_CEL&SrcApp=J_Gate_JST&DestLinkType=FullRecord&KeyUT=WOS:000374343900027&DestApp=WOS_CPL
URL
http://www.scopus.com/inward/record.url?eid=2-s2.0-84952705326&partnerID=MN8TOARS
URL
http://orcid.org/0000-0003-0995-9405

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