EVALUATION OF PROCOLLAGEN-III PEPTIDE AS A MARKER FOR VENOOCCLUSIVE DISEASE AFTER BONE-MARROW TRANSPLANTATION

Procollagen-III peptide (PIIIP) has been suggested as a marker for hep atic veno-occlusive disease (VOD) after bone marrow transplantation (B MT). Using the RIA-gnost PIIIP assay, we examined frozen plasma sample s from three groups of patients. The groups included (A) four patients with clinically proven VOD, (B) nine patients with remarkably unevent ful post-BMT courses, and (C) patients with either early complications other than VOD or pulmonary fibrosis in their later course. In group A, PIIIP levels increased parallel to the clinical course, with maximu m values of 2.7-5.5 units/ml. In group B, values did not exceed 1.4 un its/ml. In group C, higher values were occasionally observed. In one p atient with early relapse of a lymphoma PIIIP peaks correlated with ep isodes of fever and graft versus host disease (GVHD). In another patie nt mild VOD seems possible retrospectively. The highest levels (>15 un its/ml) occurred in one patient with ileus. Several patients with inte rstitial pneumonia (IF), adult respiratory distress syndrome (ARDS), o r lung fibrosis showed increases in PIIIP levels corresponding to the clinical course; most of these events occurred later than day 30 after BMT. One patient with severe GVHD of the liver showed a maximum of on ly 1.4 units/ml. PIIIP elevation correlated with clinical VOD and may help to differentiate it from hepatic GVHD. In the presence of other c omplications (pulmonary, gastrointestinal), some caution in interpreti ng the results may be advisable.