Hemostatic abnormalities following bone marrow transplantation.
Hemostatic abnormalities in 26 patients following bone marrow transplantation (BMT) were examined. In the event-free survival group, the plasma levels of antithrombin (AT) and protein C (PC) were significantly decreased 1 and 2 weeks after BMT, and the plasma levels of thrombomodulin (TM) and tissue plasminogen activator-plasminogen activator inhibitor-1 complex (tPA-PAI-I complex) were significantly increased from 4 weeks to 13 weeks after BMT. Excepting AT, there was no significant difference in hemostatic parameters before BMT among the event-free survival, 6-month survival, and death within 6 months groups. On day 0 following BMT, only plasma AT levels were significantly lower in the 6-month survival group than in the death within 6 months group. From 1 to 3 weeks after BMT, plasma levels of AT or PC were significantly lower in the death within 6 months group than in the 6-month survival group. From 1 to 5 weeks after BMT, the plasma levels of TM and tissue type plasminogen activator-plasminogen activator inhibitor-I complex (tPA-PAI-I complex) were significantly higher in the 6-month survival group than in the death within 6 months group. From 1 to 13 weeks after BMT, the plasma levels of D-dimer or soluble fibrin monomer (SFM) were significantly higher in the death within 6 months group than in the 6-month survival group. There was no remarkable difference in plasma levels of thrombin-antithrombin comlex or plasmin-plasmin inhibitor complex following BMT between these groups of patients. These findings suggest that the decrease in the plasma AT or PC level reflects early occurrence of complications of prognostic significance and that the increase in vascular endothelial cell markers such as plasma levels of TM or tPA-PAI-I complex reflects occurrence of complications during the middle course of BMT. Plasma levels of D-dimer and SFM may be useful markers for predicting complications associated with poor prognosis after BMT.
Tamaki
Shigehisa
S
Department of Internal Medicine, Yamada Red Cross Hospital, Misono-Mura, Japan.
Wada
Hideo
H
Ohfuzi
Kazuya
K
Shibata
Takeshi
T
Masuya
Masahiro
M
Kageyama
Shinichi
S
Gabazza
Esteban C
EC
Kawakami
Keiki
K
Tsuji
Kohta
K
Miyanishi
Eiki
E
Minami
Nobuyuki
N
Nobori
Tsutomu
T
Shiku
Hiroshi
H
D000328:Adult; D000990:Antithrombin III / Q000032:analysis; D019774:Blood Coagulation Factor Inhibitors / Q000032:analysis; D001779:Blood Coagulation Factors / Q000032:analysis; D016026:Bone Marrow Transplantation / Q000009:adverse effects* / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D005337:Fibrin / Q000032:analysis; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006487:Hemostasis / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D015996:Survival Rate; D018180:Thrombomodulin / Q000032:analysis
D019774:Blood Coagulation Factor Inhibitors; D001779:Blood Coagulation Factors; D005338:Fibrin Fibrinogen Degradation Products; D018180:Thrombomodulin; C036309:fibrin fragment D; D000990:Antithrombin III; D005337:Fibrin