[Usefulness of serum plasminogen activator inhibitor-1 for diagnosis and monitoring of late-onset sinusoidal obstruction syndrome after allogeneic stem cell transplantation].
Sinusoidal obstruction syndrome (SOS) was originally defined as a clinical syndrome occurring by three weeks after transplantation; however, it occurs even after three or more weeks, and such cases are called late-onset SOS. We report here a case of late-onset SOS. The patient was a 17-year-old male with acute myeloid leukemia in second complete remission. He received a preparative regimen including busulfan followed by allo-peripheral blood stem cell transplantation from an HLA-matched sibling donor. On day 28 after transplantation, he developed hepatomegaly with pain. On day 33 PAI-1 level was increased. Two days later ascites developed, leading to a diagnosis of late-onset SOS. The symptoms improved with conservative therapy and the level of PAI-1 was normalized. When hepatic impairment appears three or more weeks after transplantation, late-onset SOS should be considered. PAI-1 is a useful marker for the diagnosis and follow up of late-onset SOS.
Department of Hematology, Shizuoka Red Cross Hospital.
Satomi
S
Ito
Jun
J
Taguchi
Jun
J
Kato
Aya
A
Nakaya
Takayoshi
T
Tachibana
Sachiya
S
Takemura
Ayumi
A
Sano
Masahiko
M
Ohata
Yoshiaki
Y
Ishigatsubo
Hiroyuki
H
Fujita
D000293:Adolescent; D015415:Biomarkers / Q000097:blood*; D002066:Busulfan / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006504:Hepatic Veno-Occlusive Disease / Q000175:diagnosis* / Q000209:etiology*; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000628:therapy*; D008297:Male; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D013997:Time Factors; D019172:Transplantation Conditioning; D014184:Transplantation, Homologous
D015415:Biomarkers; D017395:Plasminogen Activator Inhibitor 1; D002066:Busulfan