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首页> 外文期刊>Medical and Pediatric Oncology: The Official Journal of the American Association for Cancer Education >Markers of endothelial function in pediatric stem cell transplantation for acute leukemia.
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Markers of endothelial function in pediatric stem cell transplantation for acute leukemia.

机译：急性白血病小儿干细胞移植中内皮功能的标志物。

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BACKGROUND: Endothelial cells and leukocytes intimately interact in inflammation and coagulation processes, so that dysregulation of their function may lead to both cellular damage and thrombosis, which may occur as complications of bone marrow transplantation (BMT). Partially conflicting evidence about endothelial markers and their relationships with clinical complications after BMT has been reported in the literature. Since almost all studies were carried out in adults, we evaluated some recent available markers of endothelial cell function in pediatric patients undergoing stem cell transplantation (SCT) for acute leukemia. PROCEDURE: We studied the variation in circulating serum endothelial-selectin (ES), leukocyte-selectin (LS), thrombomodulin (TM), von Willebrand factor (vWF), nitrate + nitrite (NO(2) (-)/NO(3) (-)), endothelin-1 (EN), and tissue factor (TF) in 21 pediatric patients undergoing SCT for acute leukemia. RESULTS: ES and LS significantly lowered following SCT and returned to pre-SCT levels 4 weeks after the procedure. NO(2) (-)/NO(3) (-) markedly increased following SCT. Also, TM and vWF increased, although such changes did not reach statistical significance. EN and TF did not appreciably change. A strong correlation was observed between white blood cell (WBC) count and both ES and LS, as well as between such selectins. TM significantly correlated with both selectins and NO(2) (-)/NO(3) (-). The pre-conditioning levels of TM and vWF in patients undergoing major complications, considered altogether, were significantly lower and higher, respectively, than in uncomplicated patients. NO(2) (-)/NO(3) (-) levels 3 and 4 weeks post-SCT were significantly lower in patients suffering from veno occlusive disease. Both selectins were significantly higher in allo- than in auto-transplanted patients 4 weeks after SCT. CONCLUSIONS: Our data support the hypothesis of severe endothelial damage after conditioning and SCT, particularly allogeneic. However, the increase in TM, which has strong anticoagulant properties, and metabolites of NO, involved also in protective actions, may reflect regeneration of the anti-thrombotic endothelial function. This could take place after transitory functional impairment, rather than pure endothelial damage.
机译：背景：内皮细胞和白细胞在炎症和凝血过程中密切相互作用，因此其功能失调可能导致细胞损伤和血栓形成，这可能是骨髓移植（BMT）的并发症。文献报道了有关BMT后内皮标志物及其与临床并发症的关系的部分矛盾证据。由于几乎所有研究都是在成人中进行的，因此我们评估了接受干细胞移植（SCT）治疗的急性白血病的小儿患者中内皮细胞功能的一些近期可用标记。程序：我们研究了循环血清内皮选择素（ES），白细胞选择素（LS），血栓调节素（TM），血管性血友病因子（vWF），硝酸盐+亚硝酸盐（NO（2）（-）/ NO（3）的变化）（-）），内皮素-1（EN）和组织因子（TF）在接受SCT治疗的急性白血病的21例儿科患者中。结果：SCT后ES和LS显着降低，并在手术后4周恢复到SCT前水平。 SCT后，NO（2）（-）/ NO（3）（-）明显增加。此外，TM和vWF有所增加，尽管这种变化没有达到统计学意义。 EN和TF没有明显变化。观察到白细胞（WBC）计数与ES和LS以及此类选择素之间存在很强的相关性。 TM与选择素和NO（2）（-）/ NO（3）（-）均显着相关。与没有并发症的患者相比，经历了主要并发症的患者的TM和vWF的预处理水平分别明显更低和更高。 SCT后3周和4周的NO（2）（-）/ NO（3）（-）水平在患有静脉闭塞性疾病的患者中显着降低。 SCT后4周，同种异体移植患者的两种选择素均显着高于同种异体移植患者。结论：我们的数据支持条件和SCT尤其是同种异体移植后严重内皮损伤的假说。然而，具有强抗凝特性的TM的增加以及也参与保护作用的NO的代谢产物可能反映了抗血栓内皮功能的再生。这可能发生在短暂的功能障碍之后，而不是单纯的内皮损伤。

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