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Post-Transplant Complications

Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome following allogeneic bone marrow transplantation

Bone Marrow Transplantation volume 29, pages 907–911 (2002)Cite this article

Abstract

We monitored the levels of various cytokines and chemokines, as well as an adhesion molecule and factors related to vascular endothelial damage, in three patients with thrombotic thrombocytopenic purpura and hemolytic uremic syndrome after bone marrow transplantation. Measurements were done at the onset of this condition and during plasma exchange for treatment. At the onset of thrombotic thrombocytopenic purpura and hemolytic uremic syndrome, the levels of interleukin-8, thrombomodulin, and plasminogen activator inhibitor-1 were all markedly increased. A close relationship was observed between improvement in symptoms by plasma exchange and a decrease in interleukin-8 level, suggesting that this chemokine may be related to the development of thrombotic thrombocytopenic purpura and hemolytic uremic syndrome after bone marrow transplantation.

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References

  1. Rabinowe SN, Soiffer RJ, Tarbell NJ et al. Hemolytic-uremic syndrome following bone marrow transplantation in adults for hematologic malignancies Blood 1991 77: 1837 1844

    CAS  PubMed  Google Scholar 

  2. Pettit AR, Clark RE . Perspective-thrombotic microangiopathy following bone marrow transplantation Bone Marrow Transplant 1994 14: 494 504

    Google Scholar 

  3. Zeigler ZR, Rosenfeld CS, Andrews DF III et al. Plasma von Willebrand factor antigen (vWF:AG) and thrombomodulin (TM) levels in adult thrombotic thrombocytopenic purpura/hemolytic uremic syndromes (TTP/HUS) and bone marrow transplant-associated thrombotic microangiopathy (BMT-TM) Am J Hematol 1996 53: 213 220

    Article  CAS  PubMed  Google Scholar 

  4. van der Plas RM, Schiphorst ME, Huizinga EG et al. von Willebrand factor proteolysis is deficient in classic, but not in bone marrow transplantation-associated, thrombotic thrombocytopenic purpura Blood 1999 93: 3798 3802

    CAS  PubMed  Google Scholar 

  5. Takatsuka H, Takemoto Y, Yamada S et al. Complications after bone marrow transplantation are manifestation of systemic inflammatory syndrome Bone Marrow Transplant 2000 26: 419 426

    Article  CAS  PubMed  Google Scholar 

  6. Takatsuka H, Takemoto Y, Okamoto T et al. Thrombotic microangiopathy following allogeneic bone marrow transplantation Bone Marrow Transplant 1999 24: 303 306

    Article  CAS  PubMed  Google Scholar 

  7. Chao NJ, Schmidt GM, Niland JC et al. Cyclosporin, methotrexate and prednisone compared with cyclosporin and prednisone for prophylaxis of acute graft-versus-host disease New Engl J Med 1993 329: 1225 1230

    Article  CAS  PubMed  Google Scholar 

  8. Wada H, Mori A, Okada M et al. Treatment of intestinal graft-versus-host disease using betamethasone enemas Transplantation 2001 72: 1451 1453

    Article  CAS  PubMed  Google Scholar 

  9. Zeigler ZR, Shadduck RK, Nemunaitis J et al. Bone marrow transplantation-associated thrombotic microangiopathy: a case series Bone Marrow Transplant 1995 15: 247 253

    CAS  PubMed  Google Scholar 

  10. Nunberger W, Michelmann I, Burdach S, Guel U . Endothelial dysfunction after bone marrow transplantation: increase of soluble thrombomodulin and PAI-1 in patients with multiple transplant-related complications Ann Hematol 1998 76: 61 65

    Article  Google Scholar 

  11. Moake JL, Rudy CK, Troll JH et al. Usually large plasma factor VIII: von Willebrand factor multimers in chronic relapsing thrombotic thrombocytopenic purpura New Engl J Med 1982 307: 1432 1435

    Article  CAS  PubMed  Google Scholar 

  12. Furlan M, Robles R, Solenthaler M et al. Deficient activity of von Willebrand factor-cleaving protease in chronic relapsing thrombotic thrombocytopenic purpura Blood 1997 89: 3097 3103

    CAS  PubMed  Google Scholar 

  13. Zeigler ZR, Shadduck RK, Nath R, Andrews DF III . Pilot study of combined cryosupernatant and protein A immunoadsorption exchange in the treatment of grade 3–4 bone marrow transplant-associated thrombotic microangiopathy Bone Marrow Transplant 1996 17: 81 86

    CAS  PubMed  Google Scholar 

  14. Milone J, Napal J, Bordone J et al. Complete response in severe thrombotic microangiopathy post bone marrow transplantation (BMT-TMA) after multiple plasmaphereses Bone Marrow Transplant 1998 22: 1019 1021

    Article  CAS  PubMed  Google Scholar 

  15. Huber AR, Kunkel SL, Todd RF III, Weiss SJ . Regulation of transendothelial neutrophil migration by endogenous interleukin-8 Science 1991 254: 99 102

    Article  CAS  PubMed  Google Scholar 

  16. Schleiffenbaum B, Moser R, Patarroyo M, Fehr J . The cell surface glycoprotein Mac-1 (CD11b/CD18) mediates neutrophil adhesion and modulates anulation independently of its quantitative cell surface expression J Immunol 1989 142: 3537 3545

    CAS  PubMed  Google Scholar 

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Acknowledgements

We wish to thank Ms R Tanaka for expert technical assistance.

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Authors and Affiliations

  1. Second Department of Internal Medicine, Hyogo College of Medicine, Hyogo, Japan

    H Takatsuka, T Wakae, A Mori, M Okada, A Suehiro, T Okamoto & E Kakishita

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  1. H Takatsuka
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  2. T Wakae
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  4. M Okada
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Takatsuka, H., Wakae, T., Mori, A. et al. Thrombotic thrombocytopenic purpura and hemolytic uremic syndrome following allogeneic bone marrow transplantation. Bone Marrow Transplant 29, 907–911 (2002). https://doi.org/10.1038/sj.bmt.1703565

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