Catani L, Gugliotta L, Vianelli N, Nocentini F, Baravelli S, Bandini G, Cirio T M, Tura S
Institute of Hematology L and A Seràgnoli, University of Bologna, Italy.
Bone Marrow Transplant. 1996 Feb;17(2):277-80.
Thrombotic complications may occur early after marrow transplantation and many data suggest that endothelial injury plays a pivotal role in their pathogenesis. Since plasma thrombomodulin and P-selectin are thought to be of value as markers of vascular endothelial cell membrane injury, we investigated their plasma concentration in bone marrow transplant patients aiming better to clarify the degree of endothelial involvement. Plasma thrombomodulin and P-selectin were monitored in 25 patients without thrombotic complications before transplant, on day 0 and weekly for 1 month thereafter, while in three patients who developed VOD monitoring continued until day +52. These proteins were in the normal range in all the uncomplicated patients and in two with reversible VOD, while they were always very high in the only patient who developed very severe and lethal VOD. In conclusion, we suggest that endothelial activation/damage occurs rarely in the course of BMT for hematological malignancies; we were able to document endothelial injury in only one patient with very severe thrombotic complication.
血栓形成并发症可能在骨髓移植后早期发生，许多数据表明内皮损伤在其发病机制中起关键作用。由于血浆血栓调节蛋白和P-选择素被认为是血管内皮细胞膜损伤的有价值标志物，我们研究了骨髓移植患者血浆中它们的浓度，以期更好地阐明内皮受累程度。对25例移植前无血栓形成并发症的患者在第0天进行血浆血栓调节蛋白和P-选择素监测，此后1个月每周监测一次，而在3例发生肝静脉闭塞病（VOD）的患者中，监测持续至+52天。所有无并发症的患者以及2例可逆性VOD患者的这些蛋白均在正常范围内，而在唯一发生非常严重且致命VOD的患者中，它们始终非常高。总之，我们认为血液系统恶性肿瘤患者在骨髓移植过程中很少发生内皮激活/损伤；我们仅在1例有非常严重血栓形成并发症的患者中证实了内皮损伤。
