title: [Hypofibrinogenemia associated with steroid therapy for the patients who developed GVHD after allogeneic stem cell transplantation].
abstract: Hypofibrinogenemia (plasma fibrinogen level <150 mg/dl) is occasionally observed after allogeneic hematopoietic stem cell transplantation, and its etiology is often difficult to determine. We herein report that steroids administered for the treatment of graft-versus-host disease (GVHD) are associated with the development of hypofibrinogenemia. We retrospectively analyzed the plasma fibrinogen (Fg) levels in 15 consecutive patients who had been administered 1 mg/kg/day (1 mg/kg group) or 2 mg/kg/day (2 mg/kg group) methylprednisolone for the treatment of Grade II to IV acute GVHD. Hypofibrinogenemia had developed in 8 of the 15 patients (53%) by day 50 after the start of steroid treatment, and was observed in 2 of 6 patients in the 1 mg/kg group and 6 of 9 in the 2 mg/kg group. A significant decrease in the Fg level was observed in the 2 mg/kg group (the median value before starting steroid treatment and that on the 20th day after starting steroid treatment were 506 mg/dl and 180 mg/dl, respectively, P=0.0013). Other possible causes of hypofibrinogenemia, including liver dysfunction or disseminated intravascular coagulation, were confirmed in only 3 patients during the observation period. In conclusion, hypofibrinogenemia commonly occurs in patients treated with steroids, especially those administered 2 mg/kg/day methylprednisolone for the treatment of GVHD.
authors.affiliation: Department of Medical Oncology and Hematology, Oita University Faculty of Medicine.
authors.forename: Yui
authors.initials: Y
authors.lastname: Moroga
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Takata
authors.forename: Natsumi
authors.initials: N
authors.lastname: Yoshida
authors.forename: Kentaro
authors.initials: K
authors.lastname: Nagamatsu
authors.forename: Yuko
authors.initials: Y
authors.lastname: Nashimoto
authors.forename: Masuho
authors.initials: M
authors.lastname: Saburi
authors.forename: Kuniko
authors.initials: K
authors.lastname: Takano
authors.forename: Taichi
authors.initials: T
authors.lastname: Ikebe
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Kohno
authors.forename: Masao
authors.initials: M
authors.lastname: Ogata
authors.forename: Kuniaki
authors.initials: K
authors.lastname: Shirao
mesh_terms: D000208:Acute Disease; D000328:Adult; D000347:Afibrinogenemia / Q000139:chemically induced*; D000368:Aged; D005260:Female; D006086:Graft vs Host Disease / Q000188:drug therapy / Q000209:etiology*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000009:adverse effects* / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D014184:Transplantation, Homologous / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D008775:Methylprednisolone