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Acute phase after haematopoietic stem cell transplantation

Journal:Hämostaseologie
ISSN:0720-9355
DOI:http://dx.doi.org/10.5482/ha-1176
Issue:Issues of 2012 (Vol. 32): Issue 1 2012 (1-86)
Pages:56-62

Acute phase after haematopoietic stem cell transplantation

Bleeding and thrombotic complications

L. Graf (1), M. Stern (1)

(1) Stem Cell Transplant Team and Division of Haematology, University Hospital Basel, Switzerland

Summary

The transplantation of allogeneic or autologous haematopoietic stem cells is an established treatment for many malignant and non-malignant diseases of the bone marrow. Intensive cytoreductive regimens administered before transplantation induce prolonged and severe cytopenia of all haematopoietic lineages. Thrombocytopenia leads to an increased risk of bleeding, which may be further aggravated by consumption of plasmatic factors as a result of tumour lysis or after antibody administration. At the same time, patients after transplantation are also at increased risk of thrombotic complications. Endothelial damage induced by radio- and chemotherapy, indwelling catheters, prolonged immobilization and a high incidence of systemic infection all contribute to the frequent occurrence of thromboembolic events in this population. This review discusses the incidence and risk factors for haemorrhagic and thrombotic complications after stem cell transplantation. Special emphasis is given to complications occurring specifically in the context of transplantation such as diffuse alveolar haemorrhage, haemorrhagic cystitis, veno-occlusive disease, and transplant associated microangiopathy.

Keywords

Haematopoietic stem cell transplantation, diffuse alveolar haemorrhage, haemorrhagic cystitis, veno-occlusive disease, transplant-associated microangiopathy

DOI

http://dx.doi.org/10.5482/ha-1176