Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
1
pubmed:dateCreated
2001-4-30
pubmed:abstractText
In this study, we retrospectively analysed the clinical features, risk factors and outcome of 22 patients with thrombotic thrombocytopenic purpura (TTP) occurring after allogeneic stem cell transplantation. All but two of these patients received stem cells from unrelated donors (UDs), two-thirds were female, three-quarters were adults and leukaemia was the major reason for transplant. The incidence of TTP was 20 out of 332 patients (6%) with UD transplants and two out of 104 recipients (2%) of matched sibling allografts (P = 0.16). In order to ascertain basic demographic risk factors for the development of TTP, we compared the 22 patients with 434 patients who did not develop TTP. Compared with patients who did not develop TTP, patients with TTP were nearly three times older (P < 0.001) and were more than twice as likely to be female (P = 0.001). Because > 90% of patients were recipients of UD marrow, we then compared the 20 UD-bone marrow transplantation (BMT) patients with 60 randomly selected UD-BMT patients who did not develop TTP. On univariate analysis, age and female gender were again significant risk factors, as was grade II-IV acute graft-versus-host disease (GvHD) (P = 0.002), and there was a trend towards an association with chronic GvHD (P = 0.083). However, after logistic regression analysis, only age and sex remained significant (P < 0.001 and 0.009 respectively). We report an 86% mortality with only three survivors out of 22 patients, and one of these remains thrombocytopenic and red cell transfusion dependent, possibly in part because of graft hypoplasia. Six out of 17 patients responded to plasmapheresis, but the majority of them ultimately succumbed because of TTP, often in association with GvHD or fungal infection.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:status
MEDLINE
pubmed:month
Apr
pubmed:issn
0007-1048
pubmed:author
pubmed:issnType
Print
pubmed:volume
113
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
58-64
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:11328282-Adolescent, pubmed-meshheading:11328282-Adult, pubmed-meshheading:11328282-Age Factors, pubmed-meshheading:11328282-Bone Marrow Transplantation, pubmed-meshheading:11328282-Child, pubmed-meshheading:11328282-Child, Preschool, pubmed-meshheading:11328282-Female, pubmed-meshheading:11328282-Graft vs Host Disease, pubmed-meshheading:11328282-Humans, pubmed-meshheading:11328282-Leukemia, pubmed-meshheading:11328282-Logistic Models, pubmed-meshheading:11328282-Male, pubmed-meshheading:11328282-Middle Aged, pubmed-meshheading:11328282-Postoperative Period, pubmed-meshheading:11328282-Purpura, Thrombotic Thrombocytopenic, pubmed-meshheading:11328282-Retrospective Studies, pubmed-meshheading:11328282-Risk Factors, pubmed-meshheading:11328282-Sex Factors, pubmed-meshheading:11328282-Transplantation, Homologous
pubmed:year
2001
pubmed:articleTitle
The clinical features, risk factors and outcome of thrombotic thrombocytopenic purpura occurring after bone marrow transplantation.
pubmed:affiliation
Bone Marrow Transplant Unit, Bristol Children's Hospital, United Bristol Healthcare Trust, Bristol, UK.
pubmed:publicationType
Journal Article