Plasminogen activator inhibitor-1 is an independent diagnostic marker as well as severity predictor of hepatic veno-occlusive disease after allogeneic bone marrow transplantation in adults conditioned with busulphan and cyclophosphamide.
We attempted to identify the diagnostic markers and severity predictors of hepatic veno-occlusive disease (VOD) in 115 adult patients who were uniformly conditioned with busulphan and cyclophosphamide and who underwent allogeneic bone marrow transplantation (BMT). A diagnosis of VOD was made according to clinical criteria. Severity of VOD was classified as mild, moderate or severe. Various haemostatic parameters were determined at five time points (d -7, 0, 7, 14 and 21). Using clinical and haemostatic parameters, we developed multivariate models to identify diagnostic markers as well as severity predictors of VOD. Of the 115 patients included in the study, 50 (43.5%) developed VOD. Twenty-nine had mild VOD, 13 moderate and 8 severe. Multiple logistic regression models showed that plasminogen activator inhibitor-1 (PAI-1) antigen (P = 0.029), percentage change of body weight (P = 0.001) and bilirubin (P < 0.001) were independent marker variables for the occurrence of VOD, and PAI-1 antigen (P = 0.030) and bilirubin (P = 0.049) were independent marker variables for the occurrence of severe VOD. Our study suggests that PAI-1 antigen can be used as a diagnostic marker as well as a severity predictor of VOD after allogeneic BMT.
Department of Medicine, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
Je-Hwan
JH
Lee
Kyoo-Hyung
KH
Lee
Jung-Hee
JH
Lee
Shin
S
Kim
Miee
M
Seol
Chan-Jeoung
CJ
Park
Hyun-Sook
HS
Chi
Weechang
W
Kang
Seung Taik
ST
Kim
Woo-Kun
WK
Kim
Jung-Shin
JS
Lee
D000293:Adolescent; D000328:Adult; D001324:Autoantigens / Q000097:blood*; D001663:Bilirubin / Q000032:analysis; D015415:Biomarkers / Q000097:blood; D001835:Body Weight; D016026:Bone Marrow Transplantation; D002066:Busulfan / Q000008:administration & dosage; D016009:Chi-Square Distribution; D003520:Cyclophosphamide / Q000008:administration & dosage; D005260:Female; D006504:Hepatic Veno-Occlusive Disease / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007938:Leukemia / Q000150:complications / Q000628:therapy*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000276:immunology*; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous
D001324:Autoantigens; D015415:Biomarkers; D007166:Immunosuppressive Agents; D017395:Plasminogen Activator Inhibitor 1; D003520:Cyclophosphamide; D002066:Busulfan; D001663:Bilirubin