Thrombotic microangiopathy associated with hematopoietic stem cell transplantation: general characteristics and an example from clinical practice

Abstract

Associated hematopoietic stem cell transplantation (HSCT) or transplant-associated thrombotic microangiopathy (TA-TMA) is currently a generally recognized and severe complication of HSCT with a high risk of mortality. TMA is characterized by microangiopathic hemolytic anemia and thrombocytopenia, resulting in the accumulation of platelets in the microvasculature, which leads to dysfunction of the ischemic organ. The pathogenesis of TА-TMA is based on endothelial damage by various trigger factors (in particular, chemotherapeutic agents in the conditioning regimen, the use of calcineurin inhibitors, alloreactivity, infectious agents). The article presents the peculiarities of terminology, pathogenesis and clinical manifestations of TA-TMA, methods of therapy for this pathology. Examples of management of patients with TA-TMA are demonstrated using a clinical example.