title: Heparin-induced thrombocytopenia after bone marrow transplantation: report of two cases.
abstract: Persistent thrombocytopenia and thrombotic complications are commonly observed in bone marrow transplant (BMT) patients. We describe two incidents following BMT in which heparin may have played a contributory role. One patient developed subclavian venous thrombosis following autologous BMT in spite of the severe thrombocytopenia. The second patient, who received an HLA-matched sibling allogeneic BMT, developed thrombocytopenia after a normal platelet recovery. Because of the clinical evidence and a normocellular bone marrow biopsy result, heparin-induced thrombocytopenia was suspected and heparin was discontinued. In 2 weeks, the patient was transfusion free and her platelet count returned to normal levels. These two cases demonstrate that heparin-induced thrombocytopenia may be responsible for some cases of post-BMT thrombocytopenia and thrombosis.
authors.affiliation: Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-3330.
authors.forename: A Z
authors.initials: AZ
authors.lastname: Tezcan
authors.forename: H
authors.initials: H
authors.lastname: Tezcan
authors.forename: D A
authors.initials: DA
authors.lastname: Gastineau
authors.forename: J O
authors.initials: JO
authors.lastname: Armitage
authors.forename: W D
authors.initials: WD
authors.lastname: Haire
mesh_terms: D000328:Adult; D016026:Bone Marrow Transplantation; D005260:Female; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D007262:Infusions, Intravenous; D015479:Leukemia, Myelomonocytic, Acute / Q000628:therapy; D008224:Lymphoma, Follicular / Q000628:therapy; D008297:Male; D010976:Platelet Count; D017713:Platelet Transfusion; D013921:Thrombocytopenia / Q000139:chemically induced*; D013924:Thrombophlebitis / Q000139:chemically induced
chemical_list: D006493:Heparin