title: Endothelial dysfunction after hematopoietic stem cell transplantation: role of the conditioning regimen and the type of transplantation.
abstract: There is endothelial activation and damage in hematopoietic stem cell transplantation (HSCT). The impact of the conditioning and type of HSCT on endothelial dysfunction in the early phases of HSCT has been evaluated. Plasma samples were obtained before and at different times after autologous and allogeneic HSCT with and without early complications. Changes in soluble markers of endothelial damage (VWF, ADAMTS-13, sVCAM-1, sICAM-1, and sTNFRI) were measured. There were changes in all markers evaluated that followed different patterns in auto and allo settings. For VWF and sTNRI, progressive increases from day Pre to day 14 and to day 21 were observed in the auto and the allo group, respectively. ADAMTS-13 activity correlated inversely with VWF levels. Levels of sVCAM-1 decreased until day 7, and raised significantly to day 14 and to day 21 in the auto and the allo HSCT, respectively. No significant changes were detected for sICAM-1. Our results confirm that there is endothelial damage at the early phases of HSCT, apparently induced by the consecutive effects of the conditioning, the proinflammatory agents used during transplantation, the translocation of endotoxins across the damaged gastrointestinal tract, and the engraftment. However, the comparative analysis between patients with and without complications suggests that none of these markers has diagnostic or prognostic value.
authors.affiliation: Hemotherapy-Hemostasis Department, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain. palomo_marta@hotmail.com
authors.forename: Marta
authors.initials: M
authors.lastname: Palomo
authors.forename: Maribel
authors.initials: M
authors.lastname: Diaz-Ricart
authors.forename: Carla
authors.initials: C
authors.lastname: Carbo
authors.forename: Montserrat
authors.initials: M
authors.lastname: Rovira
authors.forename: Francesc
authors.initials: F
authors.lastname: Fernandez-Aviles
authors.forename: Carmen
authors.initials: C
authors.lastname: Martine
authors.forename: Gabriela
authors.initials: G
authors.lastname: Ghita
authors.forename: Ginés
authors.initials: G
authors.lastname: Escolar
authors.forename: Enric
authors.initials: E
authors.lastname: Carreras
mesh_terms: D000328:Adult; D000368:Aged; D004730:Endothelium, Vascular / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D019172:Transplantation Conditioning / Q000009:adverse effects* / Q000379:methods; D016896:Treatment Outcome; D014471:Umbilical Veins / Q000473:pathology; D055815:Young Adult