Document Detail

Coagulation disturbances in paediatric patients with hepatic veno-occlusive disease after stem cells transplantation.
MedLine Citation:
PMID:  20229680     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Hepatic veno-occlusive disease (VOD) is a life threatening complication after stem cells transplantation (SCT). Its prediction, precise diagnosis and treatment remain unclear. OBJECTIVE: Our goals were to determine the incidence, outcome and changes in haemostatic parameters in patients with VOD. Also, we tried to determine coagulation disturbances and their practical significance in early diagnosis of such patients. METHODS: We prospectively evaluated all consecutive VOD patients after SCT, aged 3 months to 17 years, from February 2004 to July 2008 treated at the Mother and Child Health Institute of Serbia "Dr Vukan Cupi?" (IMD). All patients were diagnosed according to the Seattle criteria. The values of PT, aPTT, fibrinogen, FVIII, AT and vWF were measured on the day prior to the initiation of conditioning regiment and on the days 1, 7 and 14 from the moment of VOD diagnosis. Laboratory testing was performed in the IMD haemostasis laboratory and results were statistically evaluated. RESULTS: During the study period 74 SCT were performed at IMD. VOD developed 11 patients; 10 of 46 were autologous and 1 of 28 allogeneic SCT patients. In our group of patients the incidence of VOD was 14.8%. VOD was classified as mild in 7, moderate in 1 and severe in 3 patients. At the moment of establishing the diagnosis all patients had a significantly increased activity of vWF, FVIII and fibrinogen, and decreased AT. All of them were dependent on platelet transfusions. CONCLUSION: Platelet transfusion dependence suggests coagulation activation with great significance and indicates a possible development of VOD. Our results also suggest that monitoring coagulation parameters levels in the first five days from the establishment of diagnosis may have a significant predictive value for VOD outcome.
Dragana Jevti?; Dragana Vuji?; Zeljko Zecevi?; Dobrila Veljkovi?; Slobodan Gazikalovi?; Ivo Elezovi?
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Srpski arhiv za celokupno lekarstvo     Volume:  138 Suppl 1     ISSN:  0370-8179     ISO Abbreviation:  Srp Arh Celok Lek     Publication Date:  2010 Jan 
Date Detail:
Created Date:  2010-03-16     Completed Date:  2010-04-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0027440     Medline TA:  Srp Arh Celok Lek     Country:  Serbia    
Other Details:
Languages:  eng     Pagination:  33-8     Citation Subset:  IM    
Mother and Child Health Institute of Serbia "Dr. Vukan Cupi?", Belgrade, Serbia.
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MeSH Terms
Antithrombins / analysis
Blood Coagulation*
Blood Coagulation Factors / analysis
Child, Preschool
Hepatic Veno-Occlusive Disease / blood*,  etiology
Partial Thromboplastin Time
Platelet Count
Prothrombin Time
Stem Cell Transplantation / adverse effects*
Transplantation Conditioning
Reg. No./Substance:
0/Antithrombins; 0/Blood Coagulation Factors

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