Schuler U, Subat S, Schmidt H, Schneider A, Ehninger G
Department of Internal Medicine I, University Hospital of Dresden, Germany.
Ann Hematol. 1996 Jul;73(1):25-8. doi: 10.1007/s002770050194.
Procollagen-III peptide (PIIIP) has been suggested as a marker for hepatic veno-occlusive disease (VOD) after bone marrow transplantation (BMT). Using the RIA-gnost PIIIP assay, we examined frozen plasma samples from three groups of patients. The groups included (A) four patients with clinically proven VOD, (B) nine patients with remarkably uneventful post-BMT courses, and (C) patients with either early complications other than VOD or pulmonary fibrosis in their later course. In group A, PIIIP levels increased parallel to the clinical course, with maximum values of 2.7-5.5 units/ml. In group B, values did not exceed 1.4 units/ml. In group C, higher values were occasionally observed. In one patient with early relapse of a lymphoma PIIIP peaks correlated with episodes of fever and graft versus host disease (GVHD). In another patient mild VOD seems possible retrospectively. The highest levels ( > 15 units/ml) occurred in one patient with ileus. Several patients with interstitial pneumonia (IP), adult respiratory distress syndrome (ARDS), or lung fibrosis showed increases in PIIIP levels corresponding to the clinical course; most of these events occurred later than day 30 after BMT. One patient with severe GVHD of the liver showed a maximum of only 1.4 units/ml. PIIIP elevation correlated with clinical VOD and may help to differentiate it from hepatic GVHD. In the presence of other complications (pulmonary, gastrointestinal), some caution in interpreting the results may be advisable.
Ⅲ型前胶原肽（PIIIP）已被提议作为骨髓移植（BMT）后肝静脉闭塞病（VOD）的一个标志物。我们使用放射免疫分析法（RIA）检测了三组患者的冷冻血浆样本。这三组患者包括：（A）4例临床确诊为VOD的患者；（B）9例BMT后病程明显平稳的患者；（C）在病程早期出现除VOD之外的并发症或在后期出现肺纤维化的患者。在A组中，PIIIP水平随临床病程平行升高，最高值为2.7 - 5.5单位/毫升。在B组中，数值未超过1.4单位/毫升。在C组中，偶尔观察到较高的值。在1例淋巴瘤早期复发的患者中，PIIIP峰值与发热和移植物抗宿主病（GVHD）发作相关。在另一例患者中，回顾性分析似乎可能存在轻度VOD。最高水平（>15单位/毫升）出现在1例肠梗阻患者中。几例间质性肺炎（IP）、成人呼吸窘迫综合征（ARDS）或肺纤维化患者的PIIIP水平随临床病程升高；这些事件大多发生在BMT后30天之后。1例严重肝脏GVHD患者的最高值仅为1.4单位/毫升。PIIIP升高与临床VOD相关，可能有助于将其与肝脏GVHD区分开来。在存在其他并发症（肺部、胃肠道）的情况下，解释结果时可能需要谨慎。
