Authors: Heiwa Kanamori Yumiko Takaishi Maki Takabayashi Masatsugu Tanaka Satoshi Yamaji Naoto Tomita Katsumichi Fujimaki Shin Fujisawa Shinichiro Watanabe Michio Matsuzaki Yoshiaki Tshigatsubo
Publish Date: 2003/02/01
Volume: 77, Issue: 2, Pages: 180-184
Abstract
To clarify the clinical significance of the presence of fragmented red cells FRC after allogeneic bone marrow transplantation BMT we measured the incidence and degree of FRC and their relationships to clinical features The percentages of FRC FRC were measured in 50 patients on weeks20246810 and 12 The FRC in preBMT patients mean 052 range 004–156 was higher than in healthy control subjects mean 008 range 002–027 The highest FRC ≥13 were seen in 2 preBMT and 17 postBMT patients Right patients who developed thrombotic microangiopathy TMA showed FRC values that were significantly higher than those in patients without TMA However the timing of elevated FRC was delayed until several days after the onset of intravascular hemolysis and/or a drop in platelet count Of the patients who did not experience TMA 5 patients with infection and 4 patients with acute graftversushost disease GVHD also showed significant elevation of FRC during the clinical course Furthermore multivariate analysis results demonstrated that TMA and infection had a statistically significant effect on the high value of FRC These findings indicate that the appearance of FRC is a common phenomenon in patients undergoing BMT and is not a predictive factor for the early diagnosis of TMA although FRC is one of the main laboratory findings in TMA Furthermore an increased FRC is seen in other postBMT clinical settings such as infection and acute GVHD
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