Skip to main content
SpringerLink
Log in

Hämostaseologische Probleme während der Knochenmarktransplantation: Pathogenese, Diagnose und Therapie

  • Chapter
Hämostaseologie

  • 16 Accesses

Zusammenfassung

Hämostaseprobleme sind bei Patienten, die sich einer Knochenmarktransplantation (KMT) unterziehen, häufig. Zumeist handelt es sich um weniger schwerwiegende Haut- und Schleimhautblutungen. Insbesondere nach einer Konditionierung mit Busulfan oder Cyclophosphamid werden hämorrhagische Zystitiden beobachtet. Gravierende Hämostasestörungen, wie gastrointestinale Blutungen, die zumeist im Rahmen der Spendergegen-Wirt-Reaktion („graft versus host disease“, GVHD) des Darmes auftreten, Blutungen des Zentralnervensystems oder hämorrhagische Myokarditiden sind seltener, können aber lebensbedrohlich oder tödlich verlaufen.

Eine weitere Komplikation mit hoher Letalitätsrate, die mit dem Hämostasesystem in Beziehung steht, stellt die Lebervenenverschlußkrankheit („veno-occlusive disease“, VOD) dar.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 54.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Literatur

  • Atkinson K, Norrie S, Chan P et al. (1986) Hematopoietic progenitor cell function after HLA-identical sibling bone marrow transplantation: Influence of chronic graft-host disease. Int J Cell Cloning 4:203

    Article  PubMed  CAS  Google Scholar 

  • Attal M, Huguet F, Rubie H et al. (1992) Prevention of hepatic veno-occlusive disease after bone marrow transplantation by continuous infusion of low dose heparin: a prospective randomised trial. Blood 79:2834–2840

    PubMed  CAS  Google Scholar 

  • Baglin TP, Harper P, Marcus RE (1990) Venoocclusive disease of the liver complicating ABMT successfully treated with recombinant tissue plasminogen activator (rt-PA). Bone Marrow Transplantation 5:439–441

    PubMed  CAS  Google Scholar 

  • Bearman SI (1995) The syndrome of hepatic venoocclusive disease after bone marrow transplantation. Blood 85(11):3005–3019

    PubMed  CAS  Google Scholar 

  • Bearman SI, Shuhart MC, Hinds MS, McDonald GB (1992) Recombinant human tissue plasminogen activator for the treatment of established severe venocclusive disease of the liver after bone marrow transplantation. Blood 80:2458–2462

    PubMed  CAS  Google Scholar 

  • Bearman SI, Lee JL, Baron AE, McDonald GB (1997) Treatment of hepatic venocclusive disease with recombinant human tissue plasminogen activator and heparin in 42 marrow transplant patients. Blood 89:1501–1506

    PubMed  CAS  Google Scholar 

  • Catani L, Gugliotta L, Mattioli Belmonte M et al. (1993) Hypercoagulability in patients undergoing autologous or allogeneic BMT for hematological malignancies. Bone Marrow Transplantation 12:253–259

    PubMed  CAS  Google Scholar 

  • Collins P, Roderick A, O’ Brien D et al. (1994) Factor Vila and other hemostatic variables following bone marrow transplantation. Thromb Haemost 72:28–32

    PubMed  CAS  Google Scholar 

  • Devergie A, Scrobohaci ML, Drouet L et al. (1986) Changes in endothelial and coagulation parameters after allogeneic bone marrow transplant (BMT) as a mean of prediction of venoocclusive disease (VOD). Exp Haematol (Abstract) 14:430

    Google Scholar 

  • Eissner G, Kohlhuber F, Grell M et al. (1995) Critical involvement of transmembrane tumor necrosis factor α in endothelial programmed cell death mediated by ionizing radiation and bacterial endotoxin. Blood 86:4184–4193

    PubMed  CAS  Google Scholar 

  • Faioni EM, Krachmalnikoff A, Bearman SI et al. (1993) Naturally occurring anticoagulants and bone marrow transplantation: Plasma protein C predicts the development of veno-occlusive disease of the liver. Blood 81:3458–3462

    PubMed  CAS  Google Scholar 

  • First LR, Smith BR, Lipton J et al. (1985) Isolated thrombocytopenia after allogenic bone marrow transplantation: Existence of transient and chronic thrombocytopenic syndromes. Blood 665:368–374

    Google Scholar 

  • Gordon GB, Haire WD, Kessinger A et al. (1991) High frequency of antithrombin 3 and protein C deficiency following autologous bone marrow transplantation for lymphoma. Bone Marrow Transplantation 8:497–503

    PubMed  CAS  Google Scholar 

  • Harper PL, Jarvis J, Jennings I et al. (1990) Changes in the natural anticoagulants following bone marrow transplantation. Bone Marrow Transplantation 5:39–42

    PubMed  CAS  Google Scholar 

  • Holler E, Kolb HJ, Möller A et al. (1990) Increased serum levels of tumor necrosis factor α precede major complications of bone marrow transplantation. Blood 75:1011–1016

    PubMed  CAS  Google Scholar 

  • Juckett M, Perry EH, Daniels BS, Weisdorf DJ (1991) Hemolytic uremic syndrome following bone marrow transplantation. Bone Marrow Transplantation 7:405–409

    PubMed  CAS  Google Scholar 

  • Kaufmann PA, Jones RB, Greenberg CS, Peters WP (1990) Autologous bone marrow transplantation and factor XII, factor VII, and protein C deficiencies. Cancer 66:515–521

    Article  Google Scholar 

  • Leblond V, Salehian BD, Borel C et al. (1993) Alterations in natural anticoagulant levels during allogeneic bone marrow transplantation: a prospective study in 27 patients. Bone Marrow Transplantation 11:299–305

    PubMed  CAS  Google Scholar 

  • Minchinton RM, Waters AH (1985) Autoimmune thrombocytopenia and neutropenia after marrow transplantation (letter). Blood 66:752

    PubMed  CAS  Google Scholar 

  • Panella TJ, Peters W, White JG et al. (1990) Platelets acquire a secretion defect after high-dose chemotherapy. Cancer 65:1711–1716

    Article  PubMed  CAS  Google Scholar 

  • Panzer S, Kiefel V, Bartram CR et al. (1989) Immune thrombocytopenia more than a year after allogeneic bone marrow transplantation due to antibodies against donor platelets with anti-PAI1 specificity: evidence for a host-derived immune reaction. Brit J Hematol 71:259–264

    Article  CAS  Google Scholar 

  • Salat C, Holler E, Reinhardt B et al. (1994) Parameters of the fibrinolytic system in patients undergoing BMT: elevation of PAI-1 in veno-occlusive disease. Bone Marrow Transplantation 14:747–750

    PubMed  CAS  Google Scholar 

  • Salat C, Holler E, Kolb HJ et al. (1997a) Endothelial cell markers in bone marrow transplant recipients with and without acute graft versus host disease. Bone Marrow Transplant 19:909–917

    Article  PubMed  CAS  Google Scholar 

  • Salat C, Holler E, Kolb HJ et al. (1997 b) PAI-1 confirms the diagnosis of hepatic veno-occlusive disease in patients with hyperbilirubinemia after bone marrow transplantation. Blood 89:2184–2188

    PubMed  CAS  Google Scholar 

  • Scrobohaci L, Drouet L, Monem-Mansi A et al. (1991) Liver veno-occlusive disease after bone marrow transplantation. Changes in coagulation parameters and endothelial cell markers. Thromb Res 63:509–519

    Article  PubMed  CAS  Google Scholar 

  • Shulman HM, Gown AM, Nugent DJ (1987) Hepatic venoocclusive disease after bone marrow transplantation. Immunohistochemical identification of the material within occluded central venules. Am J Pathol 127:549–558

    PubMed  CAS  Google Scholar 

  • Shulman HM, Fisher LB, Schoch HG et al. (1994) Veno-occlusive disease of the liver after marrow transplantation: Histological correlates of clinical signs and symptoms. Hepatology 19:1171–1178

    Article  PubMed  CAS  Google Scholar 

  • Smith RE, Berg DD (1988) Coagulation defects in cyclosporin A treated allogeneic bone marrow transplant patients. Am J Hematol 28:137–140

    Article  PubMed  CAS  Google Scholar 

  • Tschuchnigg M, Bradstock KF, Koutts J et al. (1990) A case of thrombotic thrombocytopenic purpura following bone marrow transplantation. Bone Marrow Transplantation 5:61–63

    PubMed  CAS  Google Scholar 

Download references

Authors
  1. C. Salat
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. H. Riess
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Kerckhoff-Klinik, Abteilung Hämostaseologie und Transfusionsmedizin, Max-Planck-Institut für physiologische und klinische Forschung, Sprudelhof 11, D-61231, Bad Nauheim, Deutschland

    Gert Müller-Berghaus  & Bernd Pötzsch  & 

Rights and permissions

Reprints and permissions

Copyright information

© 1999 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Salat, C., Riess, H. (1999). Hämostaseologische Probleme während der Knochenmarktransplantation: Pathogenese, Diagnose und Therapie. In: Müller-Berghaus, G., Pötzsch, B. (eds) Hämostaseologie. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-07673-6_71

Download citation

  • DOI: https://doi.org/10.1007/978-3-662-07673-6_71

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-07674-3

  • Online ISBN: 978-3-662-07673-6

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation