[Retardation of platelet recovery after autologous stem cell transplantation in a patient with acute lymphoblastic leukemia: possible role of decreased thrombopoietin production by bone marrow stromal cells].
A 16-year-old boy was diagnosed as having acute lymphoblastic leukemia and underwent autologous stem cell transplantation at the time of his second complete remission. Retardation of platelet recovery was evident at day 90 (< 5 x 10(4)/microliter), and at day 660 after transplantation the platelet count was 8.5 x 10(4)/microliter. Neutrophils and RBCs showed only slightly retarded recovery. Bone marrow stromal cells, which are thought to play an integral role in megakaryopoiesis, were examined. Although TPO mRNA expression per cell was normal, CFU-F was significantly decreased, resulting in a decrease of total TPO mRNA expression. In contrast, expression of G-CSF mRNA per cell was increased. It was thought that chemotherapy before bone marrow transplantation may have reduced the number of stromal cells, leading to retardation of platelet recovery because of low TPO expression.
Sakamaki
S
S
Fourth Department of Internal Medicine, Sapporo Medical University, School of Medicine.
Hirayama
Y
Y
Nagaoka
Y
Y
Kuroda
H
H
Terui
K
K
Kogawa
K
K
Kato
J
J
Niitsu
Y
Y
D000293:Adolescent; D001792:Blood Platelets / Q000502:physiology*; D001854:Bone Marrow Cells / Q000378:metabolism*; D016179:Granulocyte Colony-Stimulating Factor / Q000096:biosynthesis; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D010976:Platelet Count; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000097:blood* / Q000628:therapy; D012333:RNA, Messenger / Q000096:biosynthesis; D013926:Thrombopoietin / Q000096:biosynthesis*; D014182:Transplantation, Autologous
D012333:RNA, Messenger; D016179:Granulocyte Colony-Stimulating Factor; D013926:Thrombopoietin