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Local territory-wide experience on challenges in management of transplant-associated thrombotic microangiopathy in Hong Kong
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  • Wilson Chan,
  • Alison LT Ma,
  • Eugene Chan,
  • Amanda Kan,
  • Pamela PW Lee,
  • Daniel Ka Leung Cheuk,
  • Vincent Lee,
  • Alan Chiang,
  • Wing Leung,
  • Godfrey Chan
Wilson Chan
Hong Kong Children's Hospital

Corresponding Author:wilsonykchan@graduate.hku.hk

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Alison LT Ma
Princess Margaret Hospital
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Eugene Chan
Hong Kong Children's Hospital
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Amanda Kan
Hong Kong Children's Hospital
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Pamela PW Lee
The University of Hong Kong
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Daniel Ka Leung Cheuk
Hong Kong Children's Hospital
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Vincent Lee
CUHk
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Alan Chiang
The University of Hong Kong
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Wing Leung
University of Hong Kong
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Godfrey Chan
Queen Mary Hospital
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Abstract

Transplant-associated thrombotic microangiopathy (TA-TMA) is an under-recognized yet potentially devastating complication of hematopoietic stem cell transplantation which had increased awareness in recent years. This report summarizes territory-wide experience of paediatric TA-TMA in the Hong Kong Children’s Hospital from 1 April 2019 to 31 March 2021. Total six patients were identified among 73 transplants performed. Median duration of onset was 2.5 months post-HSCT. Three patients died while all 3 survivors suffered from stage 2 to 5 chronic kidney disease despite administration of eculizumab. To conclude, recognition and diagnosis of TA-TMA is challenging. Clinical utility of complement blockage with eculizumab is limited.