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Post-Transplant Complications

Serum hyaluronic acid in patients with veno-occlusive disease following bone marrow transplantation

Bone Marrow Transplantation volume 27, pages 635–639 (2001)Cite this article

Abstract

The development of hepatic veno-occlusive disease following bone marrow transplantation is associated with high-dose combination cytoreductive therapy. Experimental models have suggested that drug-induced injury to hepatic sinusoidal endothelial cells is involved in the pathogenesis of this syndrome. Hyaluronic acid is a polysaccharide that is metabolized, almost exclusively, by hepatic sinusoidal endothelial cells. The aim of the present study was to evaluate serum hyaluronic acid as a marker for endothelial cell injury in patients with veno-occlusive disease following bone marrow transplantation. Hyaluronic acid was measured in sera from patients with and without veno-occlusive disease using an enzyme-linked protein binding assay. Mean peak serum hyaluronic acid levels were significantly greater in patients who had a diagnosis of VOD compared to those transplant patients who did not, 1173.4 ± 982.9 vs 444.9 ± 735.6 ng/ml (P = 0.01). Serial serum samples obtained from a separate cohort of patients also demonstrated that serum hyaluronic acid levels were higher in patients with moderate or severe veno-occlusive disease compared to those with none or mild disease at days 7, 17 and 25 following transplantation (greatest difference at day 25: 366 ± 327 vs126 ± 151, P = 0.01). Serum hyaluronic acid levels are increased in veno-occlusive disease and increase over time in patients with severe disease. Further studies are required to determine if elevated serum hyaluronic acid levels are due to decreased clearance by injured hepatic sinusoidal endothelial cells or increased production from early hepatic fibrogenesis associated with the acute liver injury. Bone Marrow Transplantation (2001) 27, 635–639.

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Acknowledgements

This study was funded, in part, by a grant from REAADS Medical Products and Chugai Pharmaceuticals. MWF was funded, in part, by a grant from the Carlos and Marguerite Mason Trust Fund. GBM receives funding from the National Institutes of Health, National Cancer Institute, Grant CA 18029 and CA 15704.

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Authors and Affiliations

  1. Division of Gastroenterology, Emory University School of Medicine, Atlanta, GA, USA

    MW Fried, S Soroka, J Peter, RM Strauss & TD Boyer

  2. Department of Medicine and Department of Clinical Pathology, Emory University School of Medicine, Atlanta, GA, USA

    A Duncan

  3. Division of Bone Marrow Transplantation, Emory University School of Medicine, Atlanta, GA, USA

    DG Connaghan

  4. Gastroenterology/Hepatology Section, Fred Hutchinson Cancer Research Center and University of Washington School of Medicine, Seattle, WA, USA

    A Farrand & GB McDonald

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  1. MW Fried
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Fried, M., Duncan, A., Soroka, S. et al. Serum hyaluronic acid in patients with veno-occlusive disease following bone marrow transplantation. Bone Marrow Transplant 27, 635–639 (2001). https://doi.org/10.1038/sj.bmt.1702821

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