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Endothelial Dysfunction in Hematopoietic Cell Transplantation.

Marta Palomo1,2,3, Maribel Diaz-Ricart2,3, Enric Carreras1,3

  • 1Josep Carreras Leukaemia Research Institute, Hospital Clinic/University of Barcelona Campus, Barcelona, Spain.

Clinical Hematology International
|October 1, 2021
PubMed
Summary

Endothelial damage plays a key role in early complications following hematopoietic cell transplantation (HCT). Targeting this damage may improve patient outcomes after HCT.

Keywords:
EndohteliumEndothelial dysfunctionGvHDHematopoietic stem cell transplantationInflammationTA-TMA

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Area of Science:

  • Hematology
  • Immunology
  • Transplantation Medicine

Background:

  • Hematopoietic cell transplantation (HCT) can lead to severe early complications.
  • These complications often share clinical signs suggesting underlying endothelial damage.
  • Endothelial dysfunction is increasingly recognized as a central pathophysiological mechanism.

Purpose of the Study:

  • To review the role of endothelial damage and dysfunction in early HCT complications.
  • To consolidate evidence linking endothelial injury to various post-transplant syndromes.
  • To explore therapeutic implications for preventing or treating endothelial damage.

Main Methods:

  • Review of existing literature and studies.
  • Analysis of animal and in vitro models.
  • Examination of soluble biomarkers and clinical findings.

Main Results:

  • Endothelial damage is implicated in veno-occlusive disease/sinusoidal obstructive syndrome.
  • Evidence links endothelial dysfunction to capillary leak syndrome and transplant-associated microangiopathy.
  • The endothelium is also involved in the pathophysiology of graft-versus-host disease.

Conclusions:

  • Endothelial damage is a common pathway for multiple early HCT complications.
  • Understanding endothelial dysfunction opens avenues for targeted pharmacologic interventions.
  • Therapeutic strategies aimed at protecting the endothelium could improve HCT outcomes.