Vincristine is an effective therapeutic approach for transplantation-associated thrombotic microangiopathy.

摘要

Transplantation-associated thrombotic microangiopathy (TA-TMA) is a severe complication which affects 5-74% of patients undergoing allogeneic HSCT.1 Risk factors for TA-TMA include the use of high doses of radio- and chemotherapy, infections, GVHD, and the use of cyclo-sporine (CsA) or tacrolimus.There is no consensus on the most appropriate treatment for patients with TA-TMA. The role of plasma exchange (PE) is controversial3 since response rates are considerably lower than in patients with thrombotic thrombocytopenic purpura (TTP). Thus, many patients require additional therapeutic strategies such as protein A immunoadsorption, splenectomy, nitric oxide, defibrotide, and immunosuppressive agents such as vincristine or steroids.