Changes in the natural anticoagulants following bone marrow transplantation.
The natural anticoagulants, protein C, protein S and antithrombin, were measured in 21 patients following bone marrow transplantation (BMT). The patients were divided into two groups, those with normal protein C concentration post-BMT and those with significantly reduced protein C concentrations; 12 cases fell into the second group. In addition there was an associated fall in protein S in this group of patients. In spite of the presumed hypercoagulable state only one patient developed overt veno-occlusive disease (VOD) of the liver and no other thrombotic events occurred. The fall in protein C and protein S was coincident with the peak incidence of VOD and is likely to be a contributing factor to the genesis of this condition. Only protein S measured pre-BMT was of predictive value in identifying patients likely to develop reduced levels of these anticoagulants post-BMT. Age, sex, diagnosis, type of conditioning and the pre-BMT measurement of protein C and antithrombin had no predictive value.
Harper
P L
PL
University Department of Haematology, Addenbrookes Hospital, Cambridge, UK.
Jarvis
J
J
Jennings
I
I
Luddington
R
R
Marcus
R E
RE
D000293:Adolescent; D000328:Adult; D000991:Antithrombins / Q000378:metabolism; D001777:Blood Coagulation / Q000502:physiology*; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000502:physiology*; D005260:Female; D006023:Glycoproteins / Q000097:blood; D006504:Hepatic Veno-Occlusive Disease / Q000209:etiology; D006689:Hodgkin Disease / Q000097:blood / Q000601:surgery; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000097:blood / Q000601:surgery; D008228:Lymphoma, Non-Hodgkin / Q000097:blood / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011486:Protein C / Q000378:metabolism; D017293:Protein S
D000991:Antithrombins; D006023:Glycoproteins; D011486:Protein C; D017293:Protein S