BACKGROUND AND OBJECTIVES: There are no widely accepted criteria for the definition of hematopoietic stem cell transplant -associated microangiopathy (TAM). An International Working Group was formed to develop a consensus formulation of criteria for diagnosing clinically significant TAM. DESIGN AND METHODS: The participants proposed a list of candidate criteria, selected those considered necessary, and ranked those considered optional to identify a core set of criteria. Three obligatory criteria and four optional criteria that ranked highest formed a core set. In an appropriateness panel process, the participants scored the diagnosis of 16 patient profiles as appropriate or not appropriate for TAM. Using the experts' ratings on the patient profiles as a gold standard, the sensitivity and specificity of 24 candidate definitions of the disorder developed from the core set of criteria were evaluated. A nominal group technique was used to facilitate consensus formation. The definition of TAM with the highest score formed the final RESULTS: The Working Group proposes that the diagnosis of TAM requires fulfilment of all of the following criteria: (i) >4% schistocytes in blood; (ii) de novo, prolonged or progressive thrombocytopenia (platelet count <50 x 109/L or 50% or greater reduction from previous counts); (iii) sudden and persistent increase in lactate dehydrogenase concentration; (iv) decrease in hemoglobin concentration or increased transfusion requirement; and (v) decrease in serum haptoglobin. The sensitivity and specificity of this definition exceed 80%. INTERPRETATION AND CONCLUSIONS: The Working Group recommends that the presented criteria of TAM be adopted in clinical use, especially in scientific trials.
BACKGROUND AND OBJECTIVES: There are no widely accepted criteria for the definition of hematopoietic stem cell transplant -associated microangiopathy (TAM). An International Working Group was formed to develop a consensus formulation of criteria for diagnosing clinically significant TAM. DESIGN AND METHODS: The participants proposed a list of candidate criteria, selected those considered necessary, and ranked those considered optional to identify a core set of criteria. Three obligatory criteria and four optional criteria that ranked highest formed a core set. In an appropriateness panel process, the participants scored the diagnosis of 16 patient profiles as appropriate or not appropriate for TAM. Using the experts' ratings on the patient profiles as a gold standard, the sensitivity and specificity of 24 candidate definitions of the disorder developed from the core set of criteria were evaluated. A nominal group technique was used to facilitate consensus formation. The definition of TAM with the highest score formed the final RESULTS: The Working Group proposes that the diagnosis of TAM requires fulfilment of all of the following criteria: (i) >4% schistocytes in blood; (ii) de novo, prolonged or progressive thrombocytopenia (platelet count <50 x 109/L or 50% or greater reduction from previous counts); (iii) sudden and persistent increase in lactate dehydrogenase concentration; (iv) decrease in hemoglobin concentration or increased transfusion requirement; and (v) decrease in serum haptoglobin. The sensitivity and specificity of this definition exceed 80%. INTERPRETATION AND CONCLUSIONS: The Working Group recommends that the presented criteria of TAM be adopted in clinical use, especially in scientific trials.
Authors: Rüdiger Hehlmann; David Grimwade; Bengt Simonsson; Jane Apperley; Michele Baccarani; Tiziano Barbui; Giovanni Barosi; Renato Bassan; Marie C Béné; Ute Berger; Thomas Büchner; Alan Burnett; Nicolas C P Cross; Theo J M de Witte; Hartmut Döhner; Hervé Dombret; Hermann Einsele; Georg Engelich; Robin Foà; Christa Fonatsch; Nicola Gökbuget; Elaine Gluckman; Alois Gratwohl; Francois Guilhot; Claudia Haferlach; Thorsten Haferlach; Michael Hallek; Jörg Hasford; Andreas Hochhaus; Dieter Hoelzer; Jean-Jaques Kiladjian; Boris Labar; Per Ljungman; Ulrich Mansmann; Dietger Niederwieser; Gert Ossenkoppele; José M Ribera; Harald Rieder; Hubert Serve; Petra Schrotz-King; Miguel A Sanz; Susanne Saussele Journal: Haematologica Date: 2010-11-03 Impact factor: 9.941
Authors: J Labrador; L López-Corral; O López-Godino; L Vázquez; M Cabrero-Calvo; R Pérez-López; M Díez-Campelo; F Sánchez-Guijo; E Pérez-López; C Guerrero; I Alberca; M C Del Cañizo; J A Pérez-Simón; J R González-Porras; D Caballero Journal: Bone Marrow Transplant Date: 2014-02-24 Impact factor: 5.483
Authors: Sonata Jodele; Benjamin L Laskin; Christopher E Dandoy; Kasiani C Myers; Javier El-Bietar; Stella M Davies; Jens Goebel; Bradley P Dixon Journal: Blood Rev Date: 2014-11-28 Impact factor: 8.250