{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T11:30:21Z","timestamp":1777116621107,"version":"3.51.4"},"reference-count":17,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2019,10,6]],"date-time":"2019-10-06T00:00:00Z","timestamp":1570320000000},"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":["Transfusion"],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>In the past, conventional treatment strategies for transplant\u2010associated thrombotic microangiopathy (TA\u2010TMA) have not proven to be very effective. Recently, eculizumab which is a humanized monoclonal antibody that works as a terminal complement inhibitor has demonstrated promise in the treatment landscape of TA\u2010TMA.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS AND MATERIALS<\/jats:title><jats:p>This was a single\u2010center retrospective analysis of 20 consecutive adult patients with TA\u2010TMA: 10 patients who received conventional therapy and 10 patients who received eculizumab\u2010based therapy. These patients had undergone allogeneic HSCT at MD Anderson Cancer Center between August 2011 and September 2016.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>When comparing the treatment outcomes in the two cohorts, none of the patients in the conventional therapy group obtained a hematologic or complete response according to our response criteria whereas seven patients in the eculizumab group achieved a hematologic response with one patient achieving a complete response with organ recovery. In addition, overall survival at the end of assessment was 60% in the eculizumab cohort and 30% in the conventional cohort. One major difference in practice at our institution versus previously published studies is the management of immunosuppression. In a majority of patients, tacrolimus was continued or transitioned to sirolimus for GVHD prophylaxis.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSION<\/jats:title><jats:p>Response rates and survival were improved for patients who were transitioned to sirolimus, so a two\u2010pronged approach of inhibiting complement along with providing an alternative effective immunosuppressive agent may be beneficial in the treatment of early onset TA\u2010TMA.<\/jats:p><\/jats:sec>","DOI":"10.1111\/trf.15534","type":"journal-article","created":{"date-parts":[[2019,10,6]],"date-time":"2019-10-06T08:27:33Z","timestamp":1570350453000},"page":"3519-3524","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Approaching treatment of transplant\u2010associated thrombotic Microangiopathy from two directions with Eculizumab and transitioning from Tacrolimus to Sirolimus"],"prefix":"10.1111","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1030-4545","authenticated-orcid":false,"given":"Anna S.","family":"Jan","sequence":"first","affiliation":[{"name":"Division of Pharmacy The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chitra","family":"Hosing","sequence":"additional","affiliation":[{"name":"Department of Stem Cell Transplantation and Cellular Therapy The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fleur","family":"Aung","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine Administration The University of Texas MD Anderson Cancer Center  Houston Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason","family":"Yeh","sequence":"additional","affiliation":[{"name":"Division of Pharmacy The University of Texas MD 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Texas"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2019,10,6]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bmt.1705976"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2005.06.001"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200969020-00004"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/jca.21352"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2013-05-501445"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2017.08.019"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0b013e3181f24e8d"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ejh.13127"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2006.11.020"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2016.253"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.2147\/JBM.S102235"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2016.87"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2014-06-577023"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2010.06.006"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/TP.0000000000000601"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-6143.2012.04036.x"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbmt.2016.08.005"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.15534","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/trf.15534","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/trf.15534","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T22:22:15Z","timestamp":1693347735000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/trf.15534"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,10,6]]},"references-count":17,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2019,11]]}},"alternative-id":["10.1111\/trf.15534"],"URL":"https:\/\/doi.org\/10.1111\/trf.15534","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,10,6]]},"assertion":[{"value":"2019-04-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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