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Complications after bone marrow transplantation are manifestations of systemic inflammatory response syndrome
- Source :
- Bone Marrow Transplantation. 26:419-426
- Publication Year :
- 2000
- Publisher :
- Springer Science and Business Media LLC, 2000.
-
Abstract
- Bone marrow transplantation has been established as a useful treatment for various hematological disorders and is now performed widely, but the mortality rate is still high due to various complications. A clear therapeutic policy for such complications has not yet been established because of their complex nature. We investigated whether the major complications occurring after bone marrow transplantation could be classified as aspects of the systemic inflammatory response syndrome. Subjects were 10 patients who developed severe complications after bone marrow transplantation (graft-versus-host disease, thrombotic microangiopathy, respiratory disorders, and cytomegalovirus interstitial pneumonitis) and 16 patients without complications. Their symptoms, serum cytokines, and factors related to vascular endothelial damage were compared before and after transplantation. Whereas all 10 patients who developed complications had fever in the aplastic phase after transplantation, 15 of the 16 patients without complications remained afebrile (P < 0.001, t-test). When compared with the patients who did not develop complications, the patients with complications also showed significantly higher cytokine levels during the recovery phase after transplantation (P < 0.0001, t-test). Thus, the patients with complications developed fever in the aplastic phase and showed an increase of cytokines during the recovery phase, which triggered the occurrence of vascular endothelial damage shown by factors such as the thrombomodulin and plasminogen activator inhibitor type 1. This sequence of events corresponds with that occurring during systemic inflammatory response syndrome, so many of the complications of bone marrow transplantation can be considered as manifestations of this syndrome.
- Subjects :
- Adult
Male
medicine.medical_specialty
Time Factors
Thrombotic microangiopathy
Fever
Pneumonia, Viral
Graft vs Host Disease
Inflammation
Gastroenterology
Cohort Studies
Internal medicine
medicine
Humans
Bone Marrow Transplantation
Transplantation
Vascular disease
business.industry
Microcirculation
Thrombosis
Hematology
medicine.disease
Systemic Inflammatory Response Syndrome
Surgery
Systemic inflammatory response syndrome
Pneumonia
medicine.anatomical_structure
Cytomegalovirus Infections
Cytokines
Female
Bone marrow
medicine.symptom
Lung Diseases, Interstitial
Complication
business
Subjects
Details
- ISSN :
- 14765365 and 02683369
- Volume :
- 26
- Database :
- OpenAIRE
- Journal :
- Bone Marrow Transplantation
- Accession number :
- edsair.doi.dedup.....1d8e71c05d5a781e6107aa8e745b8dda