Thrombotic microangiopathy after GVHD prophylaxis with tacrolimus/sirolimus: a call for use of consensus definition in reporting.

摘要

We read with great interest the manuscript published by Rodriguez et al describing outcomes of a phase II pilot study of a tacrolimus/ sirolimus regimen for graft-versus-host disease (GVHD) prophylaxis in 85 recipients of matched-sibling donor hematopoietic cell transplantation (HCT) using 3 different regimens (fludarabine-melphalan [Flu-Mel] = 46, total body irradiation [TBI] plus etopo-side = 28, and busulfan-cyclophosphamide [Bu/Cy] = II). The authors describe an overall incidence of posttransplantation throm-botic microangiopathy (TMA) of 19% occurring at a significantly higher rate (55%, P = .005) in patients who received conditioning with Bu/Cy.