British Journal of Haematology · 2007 · 99 citations · 6 references
MedicineHematologyImmunologyImmunotherapySepsisStem Cell TransplantationHematopoietic Stem Cell Transplant PharmacotherapyTransplant ComplicationsHematopoietic Stem Cell Transplant ComplicationsHematopoietic Stem Cell Transplantation ImmunotherapySepsis After TransplantationTherapeutic Plasma ExchangeThrombotic Complications After TransplantationTransplantation Outcome Assessment
Thrombotic microangiopathy (TMA) is a grave complication after haematopoietic stem cell transplantation (HSCT) and effective treatment is undefined. Five patients with postHSCT TMA, which was refractory to at least 1 week of plasma exchange and prednisolone, were treated with rituximab (375 mg/m(2)/week x 4). Remission was achieved in four patients, of whom three remained in remission and one had died of sepsis at a median follow-up of 10 months. ADAMTS13 levels were low in all evaluable patients, and only one patient showed significant anti-ADAMTS13 antibody. The levels of ADAMTS13 and anti-ADAMTS13 antibody did not change significantly with rituximab-induced remission.
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