HEMOSTATIC ABNORMALITIES AND INCREASED VASCULAR ENDOTHELIAL-CELL MARKERS IN PATIENTS WITH RED-CELL FRAGMENTATION SYNDROME INDUCED BY MITOMYCIN-C

Citation
S. Nagaya et al., HEMOSTATIC ABNORMALITIES AND INCREASED VASCULAR ENDOTHELIAL-CELL MARKERS IN PATIENTS WITH RED-CELL FRAGMENTATION SYNDROME INDUCED BY MITOMYCIN-C, American journal of hematology, 50(4), 1995, pp. 237-243
Citations number
28
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Hematology
ISSN journal
0361-8609
Volume
50
Issue
4
Year of publication
1995
Pages
237 - 243
Database
ISI
SICI code
0361-8609(1995)50:4<237:HAAIVE>2.0.ZU;2-V
Abstract
We examined red cell fragmentation syndrome (RCFS) induced by mitomyci n C (MMC) (13 patients), by thrombotic thrombocytopenic purpura (TTP) (17 patients), and by disseminated intravascular coagulation (DIC) (15 patients), Plasma cytokine levels were increased in the TTP and DIC p atients, but not in those whose RCFS was induced by MMC, suggesting th at the activation of the immune system plays an important role in the pathogenesis of RCFS due to TTP and DIC but did not in RCFS due to MMC , Plasma thrombomodulin, tissue type plasminogen activator, and plasmi nogen activator inhibitor-I levels were increased in all RCFS patients , suggesting that RCFS, whether MMC induced, or due to TTP or DIG, mig ht be associated with vascular endothelial cell injury, In TTP, von Wi llebrand factor (vWF) antigen and high molecular weight vWF multimer l evels were reduced, possibly as a result of microthrombus consumption, The hemostatic data in this study showed that the TTP patients were i n a hypercoagulable state without hyperfibrinolysis, and that DIC pati ents were in both a hypercoagulable and a hyperfibrinolytic state, whe reas hemostatic abnormalities were slight in patients with MMC induced RCFS, These findings suggest that vascular endothelial cell injuries might be associated with RCFS, and that those injuries in MMC-induced RCFS might not be related to microthrombi or an activated immune syste m. (C) 1995 Wiley-Liss, Inc.