{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T12:47:24Z","timestamp":1781700444211,"version":"3.54.5"},"reference-count":46,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,11,27]],"date-time":"2019-11-27T00:00:00Z","timestamp":1574812800000},"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":["Pediatric Blood &amp; Cancer"],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Transplant\u2010associated thrombotic microangiopathy (TA\u2010TMA) occurs after hematopoietic stem cell transplantation (HSCT) and is characterized by microvascular thrombosis and end\u2010organ injury particularly of the kidneys. TA\u2010TMA is challenging to diagnose and treat, which can lead to long\u2010term complications and death in patients with severe disease. Studies have shown that genetic abnormalities of the alternative complement pathway (AP) are associated with TA\u2010TMA. We hypothesized that patients with TA\u2010TMA may generate elevated levels of the AP activation product, Ba, compared with HSCT patients without TA\u2010TMA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Procedure<\/jats:title><jats:p>We longitudinally measured plasma levels of complement activation products C3a, Ba, and C5a in 14 HSCT patients: 7 with TA\u2010TMA and 7 without TA\u2010TMA. We assessed renal function by calculating estimated glomerular filtration rate (eGFR) and correlated the extent of AP activation with renal dysfunction in both patient populations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median days from HSCT to study enrollment were 154 (39\u2010237) in the TA\u2010TMA group and 84 (39\u2010253) in the HSCT group without TA\u2010TMA. Median Ba levels (ng\/mL) at enrollment were 1096.9 (826.5\u20101562.0) in the TA\u2010TMA group and 725.7 (494.7\u2010818.9) in the HSCT group without TA\u2010TMA (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.007). Over the study duration, Ba levels inversely correlated with eGFR. There were no differences in C3a, C5a, or sC5b9 levels between the two populations at any measured interval.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We conclude in this preliminary study that Ba protein may serve as a marker for TA\u2010TMA, and furthermore, that components generated in the early phase of AP activation may be involved in the pathogenesis of renal endothelial injury in TA\u2010TMA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pbc.28070","type":"journal-article","created":{"date-parts":[[2019,11,27]],"date-time":"2019-11-27T12:16:40Z","timestamp":1574857000000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["The alternative complement pathway activation product Ba as a marker for transplant\u2010associated thrombotic microangiopathy"],"prefix":"10.1002","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2204-4568","authenticated-orcid":false,"given":"Sarah","family":"Sartain","sequence":"first","affiliation":[{"name":"Department of Pediatrics Section of Hematology\u2010Oncology Baylor College of Medicine Texas Children's Hospital  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey","family":"Shubert","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Center for Cell and Gene Therapy Baylor College of Medicine Texas Children's Hospital  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng\u2010Fen","family":"Wu","sequence":"additional","affiliation":[{"name":"Biostatistics Shared Resource Dan L. Duncan Comprehensive Cancer Center Baylor College of Medicine Texas Children's Hospital  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Wang","sequence":"additional","affiliation":[{"name":"Biostatistics Shared Resource Dan L. Duncan Comprehensive Cancer Center Baylor College of Medicine Texas Children's Hospital  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caridad","family":"Martinez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Center for Cell and Gene Therapy Baylor College of Medicine Texas Children's Hospital  Houston Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,27]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000297998.33418.7e"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2006020118"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.blre.2014.11.001"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1704512"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2012.08.022"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2014.09.028"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2014.40"},{"key":"e_1_2_9_9_1","first-page":"2019;25(1):157","article-title":"Therapeutic plasma exchange does not improve renal function in hematopoietic stem cell transplantation\u2010associated thrombotic microangiopathy: an institutional experience","author":"Sartain S","journal-title":"Biol Blood Marrow Transplant"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2013.09.005"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1537-2995.2012.03776.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.transci.2016.04.007"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705976"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181f24e8d"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2016.253"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-03-564997"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2017.39"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2009.230"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000230373.82376.46"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705758"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/pbc.22861"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.02070508"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00277-017-3092-9"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e31829807aa"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-05-501445"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2015-08-663435"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/pro.5560060201"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.75.8.3948"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.4049\/jimmunol.166.4.2635"},{"issue":"11","key":"e_1_2_9_30_1","doi-asserted-by":"crossref","first-page":"3895","DOI":"10.4049\/jimmunol.141.11.3895","article-title":"C5 convertase of the alternative complement pathway: covalent linkage between two C3b molecules within the trimolecular complex enzyme","volume":"141","author":"Kinoshita T","year":"1988","journal-title":"J. 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