Laboratory markers, clinical risk factors, and complications
| Ninety allogeneic recipients . | Subjects with TMA (n = 39) . | Subjects without TMA (n = 51) . | P value . |
|---|---|---|---|
| Laboratory markers during first the 100 d after HSCT | |||
| Number of platelet transfusions in first 100 d | 13 [9.5-18] | 7 [3.5-16.5] | .03 |
| Number of red cell transfusions in first 100 d | 5 [3-7.5] | 3 [2-5] | .01 |
| Days to platelet engraftment to 20 × 109/L | 40 [18-100+] | 28.5 [20-55] | .10 |
| Days to platelet engraftment to 50 × 109/L | 58 [25-100+] | 34 [23-65] | .02 |
| AKI (doubling of serum creatinine) | 18 (46.2%) | 17 (33.3%) | .28 |
| Proteinuria ≥30 mg/dL | 26 (66.7%) | 16 (31.4%) | <.01 |
| Proteinuria lasting >2 wk | 25 (64.1%) | 15 (29.4%) | <.01 |
| Urine protein/creatinine ratio | 2.8 [1.0-3.9] | 0.8 [0.4-2.0] | .02 |
| Subjects with elevated sC5b-9 | 26/39 (67%) | 4/20 (20%) | <.01 |
| Clinical risk factors prior to the diagnosis of TMA* | |||
| Acute GVHD (any grade) | 10 (25.6%) | 10 (19.6%) | .61 |
| Cytomegalovirus viremia | 7 (18.0%) | 7 (13.7%) | .77 |
| Epstein-Barr virus viremia | 4 (10.3%) | 18 (35.3%) | .01 |
| Bacteremia | 11 (28.2%) | 16 (31.4%) | .82 |
| Invasive fungal disease | 0 (0%) | 3 (5.9%) | .26 |
| Sinusoidal obstruction syndrome | 2 (5.1%) | 0 (0%) | .19 |
| Transplant complications | |||
| Neurologic symptoms† | 9 (23%) | 4 (7.8%) | .07 |
| Number of medications to control hypertension‡ | 3 [2-4.5] | 2 [1-3] | <.01 |
| Acute dialysis | 5 (12.8%) | 3 (5.9%) | .29 |
| Intensive care admission | 18 (46.2%) | 8 (15.7%) | <.01 |
| Respiratory failure | 13 (33.3%) | 3 (5.9%) | <.01 |
| Significant gastrointestinal bleeding | 10 (25.6%) | 2 (3.9%) | <.01 |
| Pericardial effusion | 15 (38.5%) | 10 (19.6%) | .06 |
| Pulmonary hypertension | 4 (10.3%) | 0 (0%) | .03 |
| NRM at 1 y after HSCT | 17 (43.6%) | 4 (7.8%) | <.01 |
| Overall mortality at 1 y after HSCT | 18 (46.2%) | 5 (9.8%) | <.01 |
| Ninety allogeneic recipients . | Subjects with TMA (n = 39) . | Subjects without TMA (n = 51) . | P value . |
|---|---|---|---|
| Laboratory markers during first the 100 d after HSCT | |||
| Number of platelet transfusions in first 100 d | 13 [9.5-18] | 7 [3.5-16.5] | .03 |
| Number of red cell transfusions in first 100 d | 5 [3-7.5] | 3 [2-5] | .01 |
| Days to platelet engraftment to 20 × 109/L | 40 [18-100+] | 28.5 [20-55] | .10 |
| Days to platelet engraftment to 50 × 109/L | 58 [25-100+] | 34 [23-65] | .02 |
| AKI (doubling of serum creatinine) | 18 (46.2%) | 17 (33.3%) | .28 |
| Proteinuria ≥30 mg/dL | 26 (66.7%) | 16 (31.4%) | <.01 |
| Proteinuria lasting >2 wk | 25 (64.1%) | 15 (29.4%) | <.01 |
| Urine protein/creatinine ratio | 2.8 [1.0-3.9] | 0.8 [0.4-2.0] | .02 |
| Subjects with elevated sC5b-9 | 26/39 (67%) | 4/20 (20%) | <.01 |
| Clinical risk factors prior to the diagnosis of TMA* | |||
| Acute GVHD (any grade) | 10 (25.6%) | 10 (19.6%) | .61 |
| Cytomegalovirus viremia | 7 (18.0%) | 7 (13.7%) | .77 |
| Epstein-Barr virus viremia | 4 (10.3%) | 18 (35.3%) | .01 |
| Bacteremia | 11 (28.2%) | 16 (31.4%) | .82 |
| Invasive fungal disease | 0 (0%) | 3 (5.9%) | .26 |
| Sinusoidal obstruction syndrome | 2 (5.1%) | 0 (0%) | .19 |
| Transplant complications | |||
| Neurologic symptoms† | 9 (23%) | 4 (7.8%) | .07 |
| Number of medications to control hypertension‡ | 3 [2-4.5] | 2 [1-3] | <.01 |
| Acute dialysis | 5 (12.8%) | 3 (5.9%) | .29 |
| Intensive care admission | 18 (46.2%) | 8 (15.7%) | <.01 |
| Respiratory failure | 13 (33.3%) | 3 (5.9%) | <.01 |
| Significant gastrointestinal bleeding | 10 (25.6%) | 2 (3.9%) | <.01 |
| Pericardial effusion | 15 (38.5%) | 10 (19.6%) | .06 |
| Pulmonary hypertension | 4 (10.3%) | 0 (0%) | .03 |
| NRM at 1 y after HSCT | 17 (43.6%) | 4 (7.8%) | <.01 |
| Overall mortality at 1 y after HSCT | 18 (46.2%) | 5 (9.8%) | <.01 |
Data presented as median [IQR] or n (%).
Factors examined prior to the diagnosis of TMA in those subjects with TMA and any time in the first 100 days in those without TMA.
Neurological symptoms included seizures and posterior reversible encephalopathy syndrome.
Number of medications required to maintain a systolic hypertension in index <1.