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Clinical and morphological practices in the diagnosis of transplant-associated microangiopathy: a study on behalf of Transplant Complications Working Party of the EBMT

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

DOI

  • Ivan S Moiseev
  • Tatyana Tsvetkova
  • Mahmoud Aljurf
  • Randa M Alnounou
  • Janet Bogardt
  • Yves Chalandon
  • Mikhail Yu Drokov
  • Valentina Dvirnyk
  • Maura Faraci
  • Lone Smidstrup Friis
  • Fabio Giglio
  • Hildegard T Greinix
  • Brian Thomas Kornblit
  • Christiane Koelper
  • Christian Koenecke
  • Krzysztof Lewandowski
  • Dietger Niederwieser
  • Jakob R Passweg
  • Christophe Peczynski
  • Olaf Penack
  • Zinaida Peric
  • Agnieszka Piekarska
  • Paola Erminia Ronchi
  • Alicia Rovo
  • Piotr Rzepecki
  • Francesca Scuderi
  • Daniel Sigrist
  • Sanna M Siitonen
  • Friedrich Stoelzel
  • Kazimierz Sulek
  • Dimitrios A Tsakiris
  • Urszula Wilkowojska
  • Rafael F Duarte
  • Tapani Ruutu
  • Grzegorz W Basak
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Transplant-associated thrombotic microangiopathy (TA-TMA) is a life-threatening complication of allogeneic hematopoietic stem cell transplantation (HSCT). This study evaluated clinical and morphological practices of TA-TMA diagnosis in EBMT centers. Two questionnaires, one for transplant physician and one for morphologist, and also a set of electronic blood slides from 10 patients with TA-TMA and 10 control patients with various erythrocyte abnormalities, were implemented for evaluation. Seventeen EBMT centers participated in the study. Regarding criteria used for TA-TMA diagnosis, centers reported as follows: 41% of centers used the International Working Group (IWG) criteria, 41% used "overall TA-TMA" criteria and 18% used physician's decision. The threshold of schistocytes to establish TA-TMA diagnosis in the participating centers was significantly associated with morphological results of test cases evaluations (p = 0.002). The mean number of schistocytes reported from blood slide analyses were 4.3 ± 4.5% for TA-TMA cases (range 0-19.6%, coefficient of variation (CV) 0.7) and 1.3 ± 1.6% for control cases (range 0-8.3%, CV 0.8). Half of the centers reported schistocyte levels below 4% for 7/10 TA-TMA cases. The intracenter variability was low, indicating differences in the institutional practices of morphological evaluation. In conclusion, the survey identified the need for the standardization of TA-TMA morphological diagnosis.

OriginalsprogEngelsk
TidsskriftBone Marrow Transplantation
Vol/bind54
Udgave nummer7
Sider (fra-til)1022-1028
Antal sider7
ISSN0268-3369
DOI
StatusUdgivet - jul. 2019

ID: 57404175