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Prognostic implications of declining plasma gelsolin levels after allogeneic stem cell transplantation
- Source :
- Blood. 100:4367-4371
- Publication Year :
- 2002
- Publisher :
- American Society of Hematology, 2002.
-
Abstract
- The idiopathic pneumonia syndrome (IPS) represents a common and often fatal complication of hematopoietic stem cell transplantation (HSCT). Gelsolin is a highly conserved actin-binding protein normally present in plasma that may serve a basic physiological role in limiting acute lung injury of diverse etiologies. We hypothesized that depletion of circulating gelsolin following HSCT might play a permissive role in the pathogenesis of IPS. Plasma gelsolin levels were measured by immunoblotting in frozen samples obtained weekly from 24 patients undergoing allogeneic HSCT. Patients with and without IPS were similar with respect to age, diagnosis, histocompatibility differences between donor and recipient, and conditioning regimen. Mean gelsolin levels in the 9 patients with rapidly fatal IPS were significantly lower than those in patients without this complication by week 3 after HSCT (101 ± 61 mg/L versus 221 ± 54 mg/L; P = .0002). Seven (88%) of the 8 patients with gelsolin levels of less than 100 mg/L in the first month after HSCT died from IPS within 3 months; conversely, gelsolin levels fell to less than 100 mg/L in 7 (78%) of the 9 patients who died from IPS within 3 months of HSCT (P = .0007). These findings suggest that gelsolin levels shortly after allogeneic HSCT can predict the later development of fatal IPS. Gelsolin replacement in selected transplant patients may offer a novel strategy to prevent or reverse IPS.
- Subjects :
- Adult
Male
Transplantation Conditioning
Sialoglycoproteins
medicine.medical_treatment
Immunoblotting
Immunology
Graft vs Host Disease
macromolecular substances
Hematopoietic stem cell transplantation
Lung injury
Biology
Biochemistry
Idiopathic pneumonia syndrome
medicine
Humans
Transplantation, Homologous
Gelsolin
Randomized Controlled Trials as Topic
Peripheral Blood Stem Cell Transplantation
Vitamin D-Binding Protein
Pneumonia
Syndrome
Cell Biology
Hematology
Middle Aged
Prognosis
medicine.disease
Histocompatibility
Transplantation
Interleukin 1 Receptor Antagonist Protein
surgical procedures, operative
Case-Control Studies
Female
Complication
Subjects
Details
- ISSN :
- 15280020 and 00064971
- Volume :
- 100
- Database :
- OpenAIRE
- Journal :
- Blood
- Accession number :
- edsair.doi.dedup.....d8bd0100d5e1d3aa1b0ff219f7be93a5
- Full Text :
- https://doi.org/10.1182/blood-2002-06-1672