# Analysis of prognostic factors affecting TA-TMA patients: a single-center retrospective study

## TL;DR

This study identifies high creatinine levels and prior CAR-T therapy as risk factors for poor outcomes in TA-TMA patients, and suggests stopping calcineurin inhibitors may improve survival.

## Contribution

The study identifies novel independent risk factors and treatment insights for TA-TMA prognosis.

## Key findings

- High creatinine levels at diagnosis are an independent risk factor for poor TA-TMA prognosis.
- Previous CAR-T cell therapy is associated with worse outcomes in TA-TMA patients.
- Discontinuing calcineurin inhibitors may improve survival in TA-TMA patients.

## Abstract

Transplantation-associated thrombotic microangiopathy (TA-TMA) is a severe thrombotic complication that occurs after hematopoietic stem cell transplantation. Currently, there are no clear conclusions on the factors influencing the prognosis of TA-TMA patients and the best treatment plan for TA-TMA.

We retrospectively collected information on 26 patients with TA-TMA from a single center. The independent factors affecting prognosis were analyzed through univariate and multivariate Cox regression. Subgroup analysis was also conducted to investigate the impact of different treatment methods on overall survival of patients.

We found that high creatinine levels during the diagnosis of TA-TMA and previous CAR-T cell therapy were independent risk factors affecting the prognosis of TA-TMA patients. Additionally, discontinuing calcineurin inhibitors (CNI) is helpful in prolonging the survival period of TA-TMA patients.

Our research has revealed the high-risk factors affecting the survival of TA-TMA patients and the efficacy of different treatment methods, providing guidance for subsequent clinical practice.

The online version contains supplementary material available at 10.1007/s10238-025-01774-0.