Late effects on haemostasis after haematopoietic stem cell transplantation

G. Stussi; D. A. Tsakiris

doi:10.5482/ha-1184

Hämostaseologie, Table of Contents

Hamostaseologie 2012; 32(01): 63-66
DOI: 10.5482/ha-1184

Review

Schattauer GmbH

Late effects on haemostasis after haematopoietic stem cell transplantation

Spätkomplikationen der Hämostase nach hämatopoietischer Stammzelltransplantation

G. Stussi

¹Division of Haematology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland

,

D. A. Tsakiris

²Division of Haematology, Department of internal medicine, University Hospital Basel, Switzerland

› Author Affiliations

Abstract

Summary

Allogeneic and autologous hematopoietic stem cell transplantations are important therapeutic options for patients with hematologic disorders. Hemostatic complications are frequent after hematopoietic stem cell transplantation with a considerable morbidity and mortality. The incidence of bleedings and thrombosis is highest in the first few weeks after transplantation, but may also occur later. However, beyond the first year of transplantation only limited data are available. In longterm survivors the risk for premature atherosclerosis increases over time after allogeneic hematopoietic stem cell transplantation and it is higher than in the age-adjusted general population and in recipients of autologous transplantation.

Zusammenfassung

Die allogene und autologe hämatopoietische Stammzelltransplantation ist eine wichtige therapeutische Option für Patienten mit hämatologischen Erkrankungen. Komplikationen der Hämostase sind relativ häufig und verursachen eine beträchtliche Morbidität und Mortalität. Blutungen und Thrombosen treten am häufigsten in den ersten Wochen nach der Transplantation auf, es sind jedoch auch Fälle im späteren Verlauf der Transplantation beschrieben. Über hämostatische Komplikationen, die nach einem Jahr auftreten, existieren nur noch sehr wenige Daten. Bei Langzeit-Überlebenden Patienten nach allogener Stammzelltransplantation nimmt im Laufe der Zeit das Risiko für zerebro-und kardiovaskuläre Ereignisse deutlich zu. Das Risiko ist höher als in der Alters-adaptierten Allgemeinbevölkerung und in Patienten nach auto-loger Stammzelltransplantation.

Keywords

Haemostasis - venous thromboembolism - atherosclerosis - GvHD

Schlüsselwörter

Hämostase - venöse Thromboembolie - Atherosklerose - GvHD

Full Text

References

References
1 Armenian SH, Bhatia S. Cardiovascular disease after hematopoietic cell transplantation--lessons learned. Haematologica 2008; 93: 1132-1136.
2 Bhatia S. Long-term health impacts of hematopoietic stem cell transplantation inform recommendations for follow-up. Expert Rev Hematol 2011; 04: 437-452.
3 Wingard JR, Majhail NS, Brazauskas R. et al. Longterm survival and late deaths after allogeneic hematopoietic cell transplantation. J Clin Oncol 2011; 29: 2230-2239.
4 Pihusch M. Bleeding complications after hematopoietic stem cell transplantation. Semin Hematol 2004; 41: 93-100.
5 Pihusch R, Salat C, Schmidt E. et al. Hemostatic complications in bone marrow transplantation: a retrospective analysis of 447 patients. Transplantation 2002; 74: 1303-1309.
6 Gerber DE, Segal JB, Levy MY, Kane J, Jones RJ, Streiff MB. The incidence of and risk factors for venous thromboembolism (VTE) and bleeding among 1514 patients undergoing hematopoietic stem cell transplantation: implications for VTE prevention. Blood 2008; 112: 504-510.
7 Rizzo JD, Wingard JR, Tichelli A. et al. Recommended screening and preventive practices for long-term survivors after hematopoietic cell transplantation. Biol Blood Marrow Transplant 2006; 12: 138-151.
8 Gonsalves A, Carrier M, Wells PS. et al. Incidence of symptomatic venous thromboembolism following hematopoietic stem cell transplantation. J Thromb Haemost 2008; 06: 1468-1473.
9 Nadir Y, Brenner B. Hemorrhagic and thrombotic complications in bone marrow transplant recipients. Thromb Res 2007; 120 (Suppl. 02) S92-S98.
10 Pihusch M, Lohse P, Reitberger J. et al. Impact of thrombophilic gene mutations and graft-versushost disease on thromboembolic complications after allogeneic hematopoietic stem-cell transplantation. Transplantation 2004; 78: 911-918.
11 Sun C-L, Francisco L, Kawashima T. et al. Prevalence and predictors of chronic health conditions after hematopoietic cell transplantation: a report from the Bone Marrow Transplant Survivor Study. Blood 2010; 116: 3129-3139.
12 Kearon C, Kahn SR, Agnelli G. et al. Antithrombotic therapy for venous thromboembolic disease: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th ed). Chest 133 2008; 454S-545S.
13 Rysler C, Stoffel N, Buser A. et al. Effect of betablockers, Ca²⁺ antagonists, and benzodiazepines on bleeding incidence in patients with chemotherapy induced thrombocytopenia. Platelets 2010; 21: 77-83.
14 Patel AV, Hahn T, Bogner PN. et al. Fatal diffuse alveolar hemorrhage associated with sirolimus after allogeneic hematopoietic cell transplantation. Bone Marrow Transplant 2010; 45: 1363-1364.
15 Silva LdP, Patah PA, Saliba RM. et al. Hemorrhagic cystitis after allogeneic hematopoietic stem cell transplants is the complex result of BK virus infection, preparative regimen intensity and donor type. Haematologica 2010; 95: 1183-1190.
16 Najima Y, Ohashi K, Miyazawa M. et al. Intracranial hemorrhage following allogeneic hematopoietic stem cell transplantation. Am J Hematol 2009; 84: 298-301.
17 Farge D, Ribaud P, Boulay I. et al. Tibial artery thrombosis due to varicella zoster virus in a transplant recipient under cyclosporine. Eur J Med 1993; 02: 123-124.
18 Tichelli A, Passweg J, Wojcik D. et al. Late cardiovascular events after allogeneic hematopoietic stem cell transplantation: a retrospective multicenter study of the Late Effects Working Party of the EBMT. Haematologica 2008; 93: 1203-1210.
19 Baker KS, Ness KK, Steinberger J. et al. Diabetes, hypertension, and cardiovascular events in survivors of hematopoietic cell transplantation: a report from the bone marrow transplantation survivor study. Blood 2007; 109: 1765-1772.
20 Luft T, Conzelmann M, Benner A. et al. Serum cytokeratin-18 fragments as quantitative markers of epithelial apoptosis in liver and intestinal graft-versus-host disease. Blood 2007; 110: 4535-4542.
21 Biedermann BC. Vascular endothelium and graftversus-host disease. Best practice & research Clin Haematol 2008; 21: 129-138.
22 Tichelli A, Gratwohl A. Vascular endothelium as novel target of graft-versus-host disease. Best Pract Res Clin Haematol 2008; 21: 139-148.
23 Collins PW, Gutteridge CN, O’Driscoll A. et al. Von Willebrand factor as a marker of endothelial cell activation following BMT. Bone Marrow Transplant 1992; 10: 499-506.
24 Nürnberger W, Michelmann I, Burdach S, Göbel U. Endothelial dysfunction after bone marrow transplantation: increase of soluble thrombomodulin and PAI-1 in patients with multiple transplant-related complications. Ann Hematol 1998; 76: 61-65.
25 Testa S, Manna A, Porcellini A. et al. Increased plasma level of vascular endothelial glycoprotein thrombomodulin as an early indicator of endothelial damage in bone marrow transplantation. Bone Marrow Transplant 1996; 18: 383-388.
26 Pihusch M, Wegner H, Goehring P. et al. Diagnosis of hepatic veno-occlusive disease by plasminogen activator inhibitor-1 plasma antigen levels: a prospective analysis in 350 allogeneic hematopoietic stem cell recipients. Transplantation 2005; 80: 1376-1382.
27 Luft T, Dietrich S, Falk C. et al. Steroid-refractory GVHD: T-cell attack within a vulnerable endothelial system. Blood 2011; 118: 1685-1692.
28 Haug C, Duell T, Lenich A. et al. Elevated plasma endothelin concentrations in cyclosporine-treated patients after bone marrow transplantation. Bone Marrow Transplant 1995; 16: 191-194.
29 Wu Q, Chen H, Fang J. et al. Elevated Fas/FasL system and endothelial cell microparticles are involved in endothelial damage in acute graft-versus-host disease: A clinical analysis. Leuk Res. 2011 doi:10.1016/j.leukres.2011.08.005.
30 Min C-K, Kim SY, Lee MJ. et al. Vascular endothelial growth factor (VEGF) is associated with reduced severity of acute graft-versus-host disease and nonrelapse mortality after allogeneic stem cell transplantation. Bone Marrow Transplant 2006; 38: 149-156.
31 Matsuda Y, Hara J, Osugi Y. et al. Serum levels of soluble adhesion molecules in stem cell transplantation-related complications. Bone Marrow Transplant 2001; 27: 977-982.
32 Sugerman PB, Faber SB, Willis LM. et al. Kinetics of gene expression in murine cutaneous graft-versushost disease. Am J Pathol 2004; 164: 2189-2202.
33 Woywodt A, Haubitz M, Buchholz S, Hertenstein B. Counting the cost: markers of endothelial damage in hematopoietic stem cell transplantation. Bone Marrow Transplant 2004; 34: 1015-1023.
34 Woywodt A, Scheer J, Hambach L. et al. Circulating endothelial cells as a marker of endothelial damage in allogeneic hematopoietic stem cell transplantation. Blood 2004; 103: 3603-3605.
35 Martinez MT, Bucher C, Stussi G. et al. Transplantassociated microangiopathy (TAM) in recipients of allogeneic hematopoietic stem cell transplants. Bone Marrow Transplant 2005; 36: 993-1000.
36 Mii A, Shimizu A, Masuda Y. et al. Renal thrombotic microangiopathy associated with chronic humoral graft versus host disease after hematopoietic stem cell transplantation. Pathol Int 2011; 61: 34-41.
37 Biedermann BC, Sahner S, Gregor M. et al. Endothelial injury mediated by cytotoxic T lymphocytes and loss of microvessels in chronic graft versus host disease. Lancet 2002; 359: 2078-2083.
38 Penack O, Socie G, van den Brink MRM. The importance of neovascularization and its inhibition for allogeneic hematopoietic stem cell transplantation. Blood 2011; 117: 4181-4189.
39 Janin A, Deschaumes C, Daneshpouy M. et al. CD95 engagement induces disseminated endothelial cell apoptosis in vivo: immunopathologic implications. Blood 2002; 99: 2940-2947.