title: Alterations of hemostatic parameters in the early development of allogeneic hematopoietic stem cell transplantation-related complications.
abstract: Thrombotic events are common and potentially fatal complications in patients receiving hematopoietic stem cell transplantation (HSCT). Early diagnosis is crucial but remains controversial. In this study, we investigated the early alterations of hemostatic parameters in allogeneic HSCT recipients and determined their potential diagnostic values in transplantation-related thrombotic complications and other post-HSCT events. Results from 107 patients with allogeneic HSCT showed higher levels of plasma plasminogen activator inhibitor-1 (PAI-1), fibrinogen, and tissue-plasminogen activator (t-PA) and a lower level of plasma protein C after transplantation. No change was found for prothrombin time, antithrombin III, D: -dimer, and activated partial thromboplastin time following HSCT. Transplantation-related complications (TRCs) in HSCT patients were defined as thrombotic (n=8), acute graft-versus-host disease (aGVHD, n=45), and infectious (n=38). All patients with TRCs, especially the patients with thrombotic complications, presented significant increases in the mean and maximum levels of PAI-1 during the observation period. Similarly, a high maximum t-PA level was found in the thrombotic group. In contrast, apparent lower levels of mean and minimum protein C were observed in the TRC patients, especially in the aGVHD group. Therefore, the hemostatic imbalance in the early phase of HSCT, reflecting prothrombotic state and endothelial injury due to the conditioning therapy or TRCs, might be useful in the differential diagnosis of the thrombotic complication from other TRCs.
authors.affiliation: Department of Hematology, Jiangsu Institute of Hematology, The First Affiliated Hospital of Soochow University, No.188 Shi Zi Street, Suzhou, People's Republic of China. sdfyyxyk@yahoo.com
authors.forename: Yue
authors.initials: Y
authors.lastname: Han
authors.forename: Li
authors.initials: L
authors.lastname: Zhu
authors.forename: Aining
authors.initials: A
authors.lastname: Sun
authors.forename: Xiaoxu
authors.initials: X
authors.lastname: Lu
authors.forename: Luping
authors.initials: L
authors.lastname: Hu
authors.forename: Lili
authors.initials: L
authors.lastname: Zhou
authors.forename: Yongya
authors.initials: Y
authors.lastname: Ren
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Hu
authors.forename: Xiaojin
authors.initials: X
authors.lastname: Wu
authors.forename: Zhaoyue
authors.initials: Z
authors.lastname: Wang
authors.forename: Changgeng
authors.initials: C
authors.lastname: Ruan
authors.forename: Depei
authors.initials: D
authors.lastname: Wu
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006086:Graft vs Host Disease / Q000097:blood / Q000175:diagnosis*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006487:Hemostasis; D006801:Humans; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000097:blood / Q000175:diagnosis*; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011446:Prospective Studies; D011486:Protein C / Q000032:analysis; D013927:Thrombosis / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000097:blood; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D017395:Plasminogen Activator Inhibitor 1; D011486:Protein C; C051321:SERPINE1 protein, human; D005340:Fibrinogen; D010959:Tissue Plasminogen Activator