THE PRECONDITIONING INCIDENCE OF ANTIPHOSPHOLIPID ANTIBODIES IS NOT SIGNIFICANTLY INCREASED IN PATIENTS WITH BONE-MARROW TRANSPLANT-RELATEDORGAN DYSFUNCTION

Hepatic dysfunction resulting from hepatic veno-occlusive disease (VOD ) is a common complication of bone marrow transplantation (BMT). Some investigators believe that hepatic dysfunction, along with pulmonary a nd central nervous system (CNS) dysfunction, is part of a systemic dis order called multiple organ dysfunction syndrome (MODS). Endothelial d amage by pretransplant chemo-radiation and activation of hemostasis ar e considered early events in the development of hepatic VOD. The patho logical mechanism leading to fibrous obliteration of hepatic vessels m ay also take place in pulmonary and CNS vessels. Since antiphospholipi d antibodies (aPA) are associated with venous and arterial thrombosis, which can lead to vessel occlusion, we asked if the incidence of aPA before conditioning was greater in patients who developed MODS followi ng BMT. Samples drawn before pretransplant chemo-radiation from 57 pat ients who subsequently developed MODS and 55 control patients who did not develop MODS were studied blindly for aPA by ELISA. The number of aPA-positive patients who developed MODS (10/57), compared to the numb er of aPA-positive patient controls who did not develop MODS (7/55) wa s not statistically significant (P = 0.48). Our data indicate that the incidence of aPA before conditioning was not greater in patients who developed MODS, including hepatic VOD, following BMT.