Endothelial dysfunction and vascular complications after allogeneic hematopoietic cell transplantation: an expert analysis

Eftychidis, Ioannis; Sakellari, Ioanna; Anagnostopoulos, Αchilles

doi:10.1080/17474086.2021.1968823

Cited by 7 publications

(3 citation statements)

References 133 publications

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“…A three-hit hypothesis has been described for the pathogenesis of HSCT-TMA [12]. The first hit includes underlying predisposing factors: female sex, African American race, non-malignant hematological disorder, history of previous HSCT, and genetic variants [7,28]. The second hit of transplant-related risk factors, such as transplant conditioning regimen-related toxicity, total-body irradiation, unrelated donor transplantation, and human leukocyte antigen (HLA) mismatch, leads to endothelial injury, and a procoagulant state is developed [30,31].…”

Section: Hsct-tma: Complement Dysregulation and Endothelial Dysfuncti...mentioning

confidence: 99%

“…Graft-versus-host disease (GVHD) is considered the major cause of death in these patients, mainly due to infections complicating this clinical entity, while cardiovascular disease (CVD) burden is also substantially increased, as shown by both clinical and laboratory data [3][4][5][6]. Endothelial dysfunction and injury plays a substantial role in the pathogenesis of vascular complications post-HSCT, while it is also implicated in the development of HSCT-associated thrombotic microangiopathy (HSCT-TMA), veno-occlusive disease/sinusoidal obstruction syndrome (SOS/VOD), capillary leak syndrome (CLS), and GVHD [7,8]. Markers of endothelial injury such as the Endothelial Activation and Stress Index (EASIX) have been used as predictors of survival in allogeneic HSCT (alloHSCT) survivors [9,10].…”

Section: Introductionmentioning

confidence: 99%

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Genetic Susceptibility in Endothelial Injury Syndromes after Hematopoietic Cell Transplantation and Other Cellular Therapies: Climbing a Steep Hill

Evangelidis,

Kalmoukos

et al. 2024

CIMB

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Hematopoietic stem cell transplantation (HSCT) remains a cornerstone in the management of patients with hematological malignancies. Endothelial injury syndromes, such as HSCT-associated thrombotic microangiopathy (HSCT-TMA), veno-occlusive disease/sinusoidal obstruction syndrome (SOS/VOD), and capillary leak syndrome (CLS), constitute complications after HSCT. Moreover, endothelial damage is prevalent after immunotherapy with chimeric antigen receptor-T (CAR-T) and can be manifested with cytokine release syndrome (CRS) or immune effector cell-associated neurotoxicity syndrome (ICANS). Our literature review aims to investigate the genetic susceptibility in endothelial injury syndromes after HSCT and CAR-T cell therapy. Variations in complement pathway- and endothelial function-related genes have been associated with the development of HSCT-TMA. In these genes, CFHR5, CFHR1, CFHR3, CFI, ADAMTS13, CFB, C3, C4, C5, and MASP1 are included. Thus, patients with these variations might have a predisposition to complement activation, which is also exaggerated by other factors (such as acute graft-versus-host disease, infections, and calcineurin inhibitors). Few studies have examined the genetic susceptibility to SOS/VOD syndrome, and the implicated genes include CFH, methylenetetrahydrofolate reductase, and heparinase. Finally, specific mutations have been associated with the onset of CRS (PFKFB4, CX3CR1) and ICANS (PPM1D, DNMT3A, TE2, ASXL1). More research is essential in this field to achieve better outcomes for our patients.

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Section: Hsct-tma: Complement Dysregulation and Endothelial Dysfuncti...mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Genetic Susceptibility in Endothelial Injury Syndromes after Hematopoietic Cell Transplantation and Other Cellular Therapies: Climbing a Steep Hill

Evangelidis,

Kalmoukos

et al. 2024

CIMB

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“…Risk factors for SOS/VOD can be separated into transplant‐related factors (unrelated donor, HLA mismatch, non‐T cell–depleted transplant, myeloablative conditioning (MAC), busulfan or total body irradiation (TBI)–based conditioning or second HSCT), patient‐related factors (age, Karnofsky score < 90, metabolic syndrome, norethisterone exposure, advanced disease and thalassemia) and hepatic‐related factors (elevated bilirubin or transaminases, cirrhosis, active viral hepatitis, previous abdominal irradiation, previous gemtuzumab or inotuzumab, hepatotoxic drugs or iron overload) 2,7,24 …”

Section: Classification and Diagnosismentioning

confidence: 99%

Diagnosis and management of endothelial disorders following haematopoietic stem cell transplantation

McEwan,

Greenwood,

Ward

et al. 2023

Internal Medicine Journal

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Haematopoietic stem cell transplantation is a mainstay of therapy for numerous malignant and nonmalignant diseases. Endothelial activation and dysfunction occur after stem cell transplantation, driven by various patient‐ and transplant‐specific factors. This can manifest as one of the relatively uncommon endothelial injury syndromes, such as sinusoidal obstruction syndrome, transplant‐associated thrombotic microangiopathy, idiopathic pneumonia syndrome, capillary leak syndrome, engraftment syndrome or posterior reversible encephalopathy syndrome. This review focuses on the pathogenesis, classification and diagnosis of these disorders, as well as provides guidance on risk mitigation and treatment.

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Hematopoietic Stem Cell Transplantation in Patients with Inborn Errors of Immunity and Malignancy

Gennery

Slatter

2022

Interdisciplinary Cancer Research

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Endothelial dysfunction and vascular complications after allogeneic hematopoietic cell transplantation: an expert analysis

Cited by 7 publications

References 133 publications

Genetic Susceptibility in Endothelial Injury Syndromes after Hematopoietic Cell Transplantation and Other Cellular Therapies: Climbing a Steep Hill

Genetic Susceptibility in Endothelial Injury Syndromes after Hematopoietic Cell Transplantation and Other Cellular Therapies: Climbing a Steep Hill

Diagnosis and management of endothelial disorders following haematopoietic stem cell transplantation

Hematopoietic Stem Cell Transplantation in Patients with Inborn Errors of Immunity and Malignancy

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