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Significance of elevation in cell-derived microparticles after allogeneic stem cell transplantation: transient elevation of platelet-drived microparticles in TMA/TTP

Bone Marrow Transplantation volume 36, pages 921–922 (2005)Cite this article

Although stem cell transplantation (SCT) is being used for hematopoietic reconstitution following high-dose chemotherapy for malignancy, it involves some serious transplant-related complications.1 For example, graft-versus-host disease (GVHD), and vascular disorders such as veno-occlusive disease (VOD), pulmonary vasculopathy, thrombotic microangiopathy (TMA) and capillary leak syndrome, are considered to be very important. In particular, TMA is a well-recognized disorder, and several factors contribute to the onset of this complication.2 In the case of SCT, patients generally receive granulocyte colony-stimulating factor (G-CSF) after chemotherapy. The administration of G-CSF can affect serum cytokine levels of these patients,3 resulting in the generation of procoagulant factors such as platelet-derived microparticles (PDMP).4 In addition, some cytokines, such as G-CSF, IL-6 and thrombopoietin, modulate platelet activation.5 When TMA is described in patients who have undergone allogeneic SCT, it is often implied that the clinical diagnosis of TMA is similar to that of thrombotic thrombocytopenic purpura (TTP). However, TMA exhibits no symptoms at the initial stage in most cases. If it advances to a further progressive stage, a TTP-like symptom occurs. And the decrease of vWF-CPase activity is hardly recognized in TTP after bone marrow transplantation. PDMPs have been associated with TTP, and endothelial cells and monocytes can develop the same microparticles. We measured and compared the levels of microparticles and soluble factors in patients undergoing allogeneic SCT.

The subjects were 21 patients who underwent allogeneic SCT from June 2001 to February 2005 in our institutions. One of the cases developed TMA/TTP after SCT, but the other 20 cases did not. All non-TMA/TTP cases experienced degree I or II acute GVHD. In addition, none developed TMA/TTP induced by cyclosporin A. The sCD40L ELISA kit from Chemicon International Inc. (Temecula, CA, USA), and the sIL-2R, sVCAM-1 and sE-selectin ELISA kit from BioSource International, Inc. (CA, USA) were used. PDMP, monocyte-derived microparticles (MDMP), and endothelial cell-derived microparticles (EDMP) were detected by flow cytometry using a modified version of the previously reported method.6 In brief, they were detected using FITC-stained cell-specific monoclonal antibodies and PE-stained Annexin V by two color flow cytometric analysis.

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Authors and Affiliations

  1. Department of Hematology, Kishiwada City Hospital, Kishiwada, Osaka, Japan

    S Nomura & K Ishii

  2. Department of Internal Medicine, Kansai Medical Kohri Hospital, Neyagawa, Osaka, Japan

    S Kanazawa & N Inami

  3. Department of Internal Medicine, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan

    N Uoshima

  4. Department of Pediatrics, Matsushita Memorial Hospital, Moriguchi, Osaka, Japan

    H Ishida & T Yoshihara

  5. Department of Internal Medicine, Hoshigaoka Koseinennkinn Hospital, Moriguchi, Osaka, Japan

    H Kitayama & K Hayashi

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  1. S Nomura
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Nomura, S., Ishii, K., Kanazawa, S. et al. Significance of elevation in cell-derived microparticles after allogeneic stem cell transplantation: transient elevation of platelet-drived microparticles in TMA/TTP. Bone Marrow Transplant 36, 921–922 (2005). https://doi.org/10.1038/sj.bmt.1705150

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