Plasma protein C is a useful clinical marker for hepatic veno-occlusive disease (VOD) in stem cell transplantation.

Abstract:

BACKGROUND:Hepatic veno-occlusive disease (VOD) is one of the most serious complications in stem cell transplantation (SCT). Although plasma protein C activity decreases in VOD after SCT, the timeframe of plasma protein C activity decreases during SCT is not known. PROCEDURE:We examined levels of plasma protein C serially during the course of SCT to determine the critical level and risk factors for VOD. RESULTS:Of 151 children who received SCT, 12 of them (7.9%) developed VOD. The mean minimum protein C activity in patients with VOD was significantly lower compared to that in patients without VOD (P < 0.0001). Receiver operating characteristic curve analysis revealed that the critical plasma protein C activity (cut-off point) for VOD was identified to be 34.5% with high sensitivity (100%) and specificity (83.3%), and the reduction of plasma protein C below the cut-off level (day +6.50 +/- 2.43) was observed mostly prior to the onset of VOD (day +7.33 +/- 2.64). The patients receiving melphalan in conditioning were found to be at high risk for VOD (P = 0.003). Among the melphalan containing regimens, melphalan + carboplatin + etoposide was a significant risk factor for depression of plasma protein C (P = 0.037). CONCLUSION:Plasma protein C level was a useful parameter of VOD after SCT, and activity below 34.5% was critical for VOD. The use of melphalan in conditioning causes a high risk for VOD.

journal_name

Pediatr Blood Cancer

journal_title

Pediatric blood & cancer

authors

Iguchi A,Kobayashi R,Kaneda M,Kobayashi K

doi

10.1002/pbc.22314

subject

Has Abstract

pub_date

2010-03-01 00:00:00

pages

437-43

issue

3

eissn

1545-5009

issn

1545-5017

journal_volume

54

pub_type

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