{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:07:43Z","timestamp":1790791663039,"version":"4.1.0"},"reference-count":35,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2020,8,8]],"date-time":"2020-08-08T00:00:00Z","timestamp":1596844800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Hematol"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Transplant\u2010associated thrombotic microangiopathy (TA\u2010TMA) has a wide range of presentations after hematopoietic stem\u2010cell transplantation (HSCT). We retrospectively studied the risk factors and outcomes of patients with early (\u2264day 100) and late (&gt;day 100) TA\u2010TMA. Among the 1451 HSCT recipients, early TA\u2010TMA occurred in 45 (3.1%) patients at a median of 27 (3\u201091) days, and late TA\u2010TMA in 39 (2.7%) patients at a median of 303 (122\u20102595) days. Patients with early TA\u2010TMA were more likely to have high blood calcineurin\u2010inhibitor levels (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) and acute graph\u2010vs\u2010host disease (GVHD, <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001), while late TMA patients were more likely to have chronic GVHD (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). The estimated median overall survival after onset of TMA for the entire cohort was 6 months. The estimated median overall survival was not reached in patients with an improvement of TMA vs 2 months in patients with no improvement (<jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). In the early TMA group, older age (for every 10\u2009years, HR 1.40; 95% CI 1.00\u20101.94; <jats:italic>P<\/jats:italic> = .049) and bacterial infection (HR 2.42; 95% CI 0.98\u20106.00; <jats:italic>P<\/jats:italic> = .056) were positively associated with mortality. Switching to MMF treatment (HR 0.40; 95% CI 0.16\u20100.99; <jats:italic>P<\/jats:italic> = .047) and improvement of TMA (HR 0.08; 95% CI 0.03\u20100.25; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001) were negatively associated with mortality in the multivariate analysis. In the late TMA group, the improvement of TMA was the only independent predictor associated with a lower risk of death (HR 0.05; 95% CI 0.02\u20100.19; <jats:italic>P<\/jats:italic>\u2009&lt;\u2009.001). Mortality rates in both early and late TMA remain unacceptably high. Future studies are needed for early diagnosis, trigger identifications, and use of targeted treatments.<\/jats:p>","DOI":"10.1002\/ajh.25922","type":"journal-article","created":{"date-parts":[[2020,7,3]],"date-time":"2020-07-03T05:24:55Z","timestamp":1593753895000},"page":"1170-1179","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":25,"title":["Characteristics of late transplant\u2010associated thrombotic microangiopathy in patients who underwent allogeneic hematopoietic stem cell transplantation"],"prefix":"10.1002","volume":"95","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7903-1106","authenticated-orcid":false,"given":"Cihan","family":"Heybeli","sequence":"first","affiliation":[{"name":"Division of Nephrology Dokuz Eylul University School of Medicine  Izmir 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