Transplantation-associated thrombotic microangiopathy: twenty-two years later

Bone Marrow Transplant. 2002 Dec;30(11):709-15. doi: 10.1038/sj.bmt.1703710.


A syndrome of microangiopathic hemolytic anemia, renal dysfunction and neurological abnormalities was first noted in bone marrow transplant recipients 22 years ago. Now known as transplantation-associated thrombotic microangiopathy (TA-TMA) to distinguish it from other thrombotic microangiopathies, this disorder responds poorly to conventional treatments for thrombotic thrombocytopenic purpura. In this review, we discuss the incidence and risk factors for TA-TMA and describe a pathophysiologic model of the disorder based on results obtained from laboratory models of the thrombotic microangiopathies. We conclude by suggesting possible approaches to the early diagnosis and treatment of TA-TMA based on this model that may warrant testing in future clinical trials.

Publication types

  • Review

MeSH terms

  • Bone Marrow Transplantation / adverse effects*
  • Disease Models, Animal
  • Endothelium, Vascular / pathology
  • Humans
  • Microcirculation / pathology
  • Purpura, Thrombotic Thrombocytopenic
  • Thrombocytopenia / diagnosis
  • Thrombocytopenia / epidemiology
  • Thrombocytopenia / etiology*
  • Thrombocytopenia / therapy