ENDOTHELIUM AND BONE-MARROW TRANSPLANTATION

Thrombotic complications may occur early after marrow transplantation and many data suggest that endothelial injury plays a pivotal role in their pathogenesis. Since plasma thrombomodulin and P-selectin are tho ught to be of value as markers of vascular endothelial cell membrane i njury, we investigated their plasma concentration in bone marrow trans plant patients aiming better to clarify the degree of endothelial invo lvement. Plasma thrombomodulin and P-selectin were monitored in 25 pat ients without thrombotic complications before transplant, on day 0 and weekly for 1 month thereafter, while in three patients who developed VOD monitoring continued until day +52. These proteins were in the nor mal range in all the uncomplicated patients and in two with reversible VOD, while they were always very high in the only patient who develop ed very severe and lethal VOD, In conclusion, we suggest that endothel ial activation/damage occurs rarely in the course of BMT for hematolog ical malignancies; we were able to document endothelial injury in only one patient with very severe thrombotic complication.