Early hemostatic alterations following bone marrow transplantation: a prospective study

Area of Science:

• Hematology
• Transplantation Medicine
• Thrombosis Research

Background:

• Coagulation system alterations post-bone marrow transplantation (BMT) and their role in thrombotic complications like liver veno-occlusive disease (VOD) are debated.
• Prospective evaluation of hemostatic balance changes in the early period after BMT (up to day +21) is needed.

Purpose of the Study:

• To prospectively evaluate alterations in hemostatic balance during the early period after BMT (up to day +21).
• To investigate the relationship between hemostatic alterations and the occurrence of VOD.

Main Methods:

• Prospective study of 29 patients undergoing autologous or allogeneic BMT.
• Monitoring of coagulation parameters, including fibrinogen, factor VIII activity, von Willebrand factor antigen, factor VII antigen, protein C, and plasminogen.
• Assessment of thrombotic and hemorrhagic events.

Main Results:

• Progressive increase in fibrinogen, factor VIII activity (fVIII:C), and von Willebrand factor antigen (vWf) observed.
• Significant decrease in factor VII antigen (fVIIAg), protein C, and plasminogen levels.
• Alterations peaked around day +14, trending towards normal levels by day +21. No significant changes in PT, PTT, F 1+2, fXIIC, tPA, PAI-1, D dimer, protein S, or TNF-alpha.

Conclusions:

• Early hemostatic system alterations, likely due to endothelial damage, are detectable after BMT.
• The clinical significance of these hemostatic changes is uncertain due to the lack of correlation with thrombotic complications.