Abstract
In twelve allogenic bone marrow transplanted patients with hematologic and other malignancy and in eight autologous bone marrow transplanted patients, serial hemostatic changes were evaluated at -14, -7, 0, +7, +14 and +28 bone marrow transplanted days. Hemostatic parameters such as plasma fibrinogen, factor V, fibrin degradation products (FDP) and α1 proteinase inhibitor (α1PI) tended to increase and activated thromboplastin time (APTT) to prolong after bone marrow transplantation. On the contrary, antithrombin III (AT III), α2 plasmin inhibitor (α2PI) and plasminogen had a tendency to decrease in each level after bone marrow transplantation with relatively stable values of α2 macroglobulin (α2M) and prothrombin time (PT). The same pattern were noticed typically and severely in 3 cases of hepatic venooccluslve disease and 2 cases of interstitial pneumonia, in whom disseminated intravascular coagulation (DIC) developed.
From the facts that the dynamic changes ln levels of ATIII and plasminogen were well correlated with concentrations of albumin and total protein in plasma, and that the presence of α2PI-plasmin complex and antlthrombin III-thrombin complex was not found in bone marrow transplanted patients, it was concluded that the mechanisms of decline of ATIII, plasmlnogen and α2 PI are not due to active consumption like intravascular coagulation but to decreased production in the llver.
