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Post-Transplant Events

Protein C and procollagen III peptide levels in patients with hepatic dysfunction after allogeneic hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 36, pages 631–637 (2005)Cite this article

Summary:

Veno-occlusive disease (VOD) is one of the most serious complications following hematopoietic stem cell transplantation (HSCT) and is associated with a high mortality. We conducted a large trial on the clinical significance of protein C (PC) and procollagen III peptide (PNPIII) levels, which have been described as possible diagnostic markers of VOD. In total, 350 patients undergoing allogeneic HSCT were included. PC and PNPIII levels were analyzed prior to conditioning and weekly until 8 weeks after the HSCT. Signs of VOD and other transplantation-related complications (graft-versus-host disease (GVHD), toxicity, microangiopathic hemolytic anemia, infection) were recorded weekly throughout the trial. Patients showed a significant drop of the PC levels in VOD (70.3 vs 96.3%, P<0.001) and with increasing severity of aGVHD. Steroids increased the PC levels (69.4% vs 109.4%, P<0.001). The highest PNPIII levels were registered in patients with VOD (mean 6.3 IU/ml). Patients with aGVHD showed an elevation of PNPIII, especially patients with hepatic aGVHD. PC levels during conditioning do not predict VOD (98.5 vs 76.5%, NS). Although PC and PNPIII may play a role in the pathogenesis of VOD they cannot discriminate between complications with jaundice and are only of limited help in the differential diagnosis of VOD.

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Acknowledgements

This work is part of the doctoral thesis of Holger Wegner.

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Authors and Affiliations

  1. Abteilung fuer Haematologie und Internistische Onkologie, Klinikum der Universitaet Regensburg, Regensburg, Germany

    M Pihusch, P Goehring, R Andreesen & E Holler

  2. Medizinische Klinik III – Grosshadern, Klinikum der Ludwig Maximilians-Universitaet Muenchen, Muenchen, Germany

    H Wegner, P Goehring, C Salat, V Pihusch, H-J Kolb, E Holler & R Pihusch

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  1. M Pihusch
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  2. H Wegner
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  4. C Salat
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  8. E Holler
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Correspondence to M Pihusch.

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Pihusch, M., Wegner, H., Goehring, P. et al. Protein C and procollagen III peptide levels in patients with hepatic dysfunction after allogeneic hematopoietic stem cell transplantation. Bone Marrow Transplant 36, 631–637 (2005). https://doi.org/10.1038/sj.bmt.1705114

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