Sletnes K E, Holte H, Halvorsen S, Jakobsen E, Wisløff F, Kvaløy S
Haematological Research Laboratory, Ullevål University Hospital, Oslo, Norway.
Bone Marrow Transplant. 1996 Apr;17(4):577-81.
Evidence of activation of coagulation was sought in serial plasma samples from 25 ABMT candidates with malignant lymphoma admitted for bone marrow harvesting: 10 females and 15 males, median age 41 years (range 27-58 years). Nineteen patients had non-Hodgkin's lymphoma (NHL) and six had Hodgkin's disease. Of those with NHL, 14 had high-grade and five low- grade disease. The plasma levels of markers of activation (prothrombin fragment 1 + 2, thrombin-antithrombin complexes, fibrinopeptide A and fibrinmonomers) increased significantly (P < 0.001) in association with harvesting. Except for fibrinopeptide A, the indicators of activation were still significantly elevated 24 h after marrow aspiration. Beta-thromboglobulin, a marker of the platelet release reaction, also increased significantly (P < 0.01). Four out of nine patients in whom a long-term central venous catheter was inserted just after marrow aspiration, developed catheter-related deep vein thrombosis, verified venographically, shortly after harvesting. These results suggest that patient with malignant lymphoma undergoing marrow harvesting develop a hypercoagulable state, and that insertion of a central intravenous catheter immediately after marrow harvesting should be avoided to prevent the development of symptomatic deep vein thrombosis.
在25名因骨髓采集而入院的恶性淋巴瘤自体骨髓移植候选者的系列血浆样本中寻找凝血激活的证据：10名女性和15名男性，中位年龄41岁（范围27 - 58岁）。19例患者患有非霍奇金淋巴瘤（NHL），6例患有霍奇金病。在患有NHL的患者中，14例为高级别疾病，5例为低级别疾病。激活标志物（凝血酶原片段1 + 2、凝血酶 - 抗凝血酶复合物、纤维蛋白肽A和纤维蛋白单体）的血浆水平在采集过程中显著升高（P < 0.001）。除纤维蛋白肽A外，激活指标在骨髓抽吸后24小时仍显著升高。β-血小板球蛋白，一种血小板释放反应的标志物，也显著升高（P < 0.01）。9例在骨髓抽吸后立即插入长期中心静脉导管的患者中，有4例在采集后不久经静脉造影证实发生了导管相关的深静脉血栓形成。这些结果表明，接受骨髓采集的恶性淋巴瘤患者会出现高凝状态，并且应避免在骨髓采集后立即插入中心静脉导管以预防有症状的深静脉血栓形成的发生。
