Graft-Versus-Host Disease Sustains Coagulation Activity for two Years After Pediatric Allogeneic Hematopoietic Stem Cell Transplantation
Aim To evaluate the longitudinal coagulation profile after allogeneic hematopoietic stem cell transplantation (HSCT) in pediatric patients with hematological malignancies. Methods Several coagulation variables were measured at predetermined time points for two years after HSCT in 30 pediatric patien...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2025-02-01
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| Series: | Clinical and Applied Thrombosis/Hemostasis |
| Online Access: | https://doi.org/10.1177/10760296241304771 |
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| author | Satu Långström MD, PhD Minna Koskenvuo MD, PhD Pasi Huttunen MD, PhD Riitta Lassila MD, PhD Mervi Taskinen MD, PhD Susanna Ranta MD, PhD Markku Heikinheimo MD, PhD Anne Mäkipernaa MD, PhD |
| author_facet | Satu Långström MD, PhD Minna Koskenvuo MD, PhD Pasi Huttunen MD, PhD Riitta Lassila MD, PhD Mervi Taskinen MD, PhD Susanna Ranta MD, PhD Markku Heikinheimo MD, PhD Anne Mäkipernaa MD, PhD |
| author_sort | Satu Långström MD, PhD |
| collection | DOAJ |
| description | Aim To evaluate the longitudinal coagulation profile after allogeneic hematopoietic stem cell transplantation (HSCT) in pediatric patients with hematological malignancies. Methods Several coagulation variables were measured at predetermined time points for two years after HSCT in 30 pediatric patients. Results At six months post-HSCT, endothelial activation was reflected by 1.4-fold increase in circulating von Willebrand factor activity (p < 0.05), and by 2-fold increase in thrombin-antithrombin complex levels (p < 0.05), suggesting sustained coagulation system activity. In six patients with chronic graft-versus-host disease (cGVHD), specifically in those having gastrointestinal (GI) tract cGVHD, we observed continued longitudinal alterations in the coagulation system. The activities of both, coagulation factors (FV, FVII, FVIII, fibrinogen), and natural anticoagulants (antithrombin and protein C) were higher than prior to conditioning (p < 0.05) at most time points in patients with cGVHD. Moreover, fibrin turnover marker D-dimer was elevated from 6 to 18 months after HSCT (p < 0.05). Conclusion Pediatric patients undergoing HSCT demonstrate prolonged derangement of the coagulation system, with a new alleviating balance after 6 months post-HSCT. However, in patients with cGVHD, and in particular when cGVHD affects the GI tract, the persisting derangement of coagulation suggest its contributing role in cGVHD and related complications. |
| format | Article |
| id | doaj-art-87ba542e571a4de29d31ed49f912e7d0 |
| institution | Kabale University |
| issn | 1938-2723 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Clinical and Applied Thrombosis/Hemostasis |
| spelling | doaj-art-87ba542e571a4de29d31ed49f912e7d02025-02-05T08:03:48ZengSAGE PublishingClinical and Applied Thrombosis/Hemostasis1938-27232025-02-013110.1177/10760296241304771Graft-Versus-Host Disease Sustains Coagulation Activity for two Years After Pediatric Allogeneic Hematopoietic Stem Cell TransplantationSatu Långström MD, PhD0Minna Koskenvuo MD, PhD1Pasi Huttunen MD, PhD2Riitta Lassila MD, PhD3Mervi Taskinen MD, PhD4Susanna Ranta MD, PhD5Markku Heikinheimo MD, PhD6Anne Mäkipernaa MD, PhD7 Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland Department of Pediatrics, Turku University Hospital, , Turku, Finland Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland Unit for Coagulation Disorders, Department of Hematology, Comprehensive Care Center and Cancer Center, Helsinki University Hospital, and Research Program Unit in Systems Oncology, , Helsinki, Finland Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland Astrid Lindgren Children's Hospital, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden Faculty of Medicine and Health Technology, Center for Child, Adolescent, and Maternal Health Research, Tampere University, Tampere, Finland Unit for Coagulation Disorders, Department of Hematology, Comprehensive Care Center and Cancer Center, Helsinki University Hospital, and Research Program Unit in Systems Oncology, , Helsinki, FinlandAim To evaluate the longitudinal coagulation profile after allogeneic hematopoietic stem cell transplantation (HSCT) in pediatric patients with hematological malignancies. Methods Several coagulation variables were measured at predetermined time points for two years after HSCT in 30 pediatric patients. Results At six months post-HSCT, endothelial activation was reflected by 1.4-fold increase in circulating von Willebrand factor activity (p < 0.05), and by 2-fold increase in thrombin-antithrombin complex levels (p < 0.05), suggesting sustained coagulation system activity. In six patients with chronic graft-versus-host disease (cGVHD), specifically in those having gastrointestinal (GI) tract cGVHD, we observed continued longitudinal alterations in the coagulation system. The activities of both, coagulation factors (FV, FVII, FVIII, fibrinogen), and natural anticoagulants (antithrombin and protein C) were higher than prior to conditioning (p < 0.05) at most time points in patients with cGVHD. Moreover, fibrin turnover marker D-dimer was elevated from 6 to 18 months after HSCT (p < 0.05). Conclusion Pediatric patients undergoing HSCT demonstrate prolonged derangement of the coagulation system, with a new alleviating balance after 6 months post-HSCT. However, in patients with cGVHD, and in particular when cGVHD affects the GI tract, the persisting derangement of coagulation suggest its contributing role in cGVHD and related complications.https://doi.org/10.1177/10760296241304771 |
| spellingShingle | Satu Långström MD, PhD Minna Koskenvuo MD, PhD Pasi Huttunen MD, PhD Riitta Lassila MD, PhD Mervi Taskinen MD, PhD Susanna Ranta MD, PhD Markku Heikinheimo MD, PhD Anne Mäkipernaa MD, PhD Graft-Versus-Host Disease Sustains Coagulation Activity for two Years After Pediatric Allogeneic Hematopoietic Stem Cell Transplantation Clinical and Applied Thrombosis/Hemostasis |
| title | Graft-Versus-Host Disease Sustains Coagulation Activity for two Years After Pediatric Allogeneic Hematopoietic Stem
Cell Transplantation |
| title_full | Graft-Versus-Host Disease Sustains Coagulation Activity for two Years After Pediatric Allogeneic Hematopoietic Stem
Cell Transplantation |
| title_fullStr | Graft-Versus-Host Disease Sustains Coagulation Activity for two Years After Pediatric Allogeneic Hematopoietic Stem
Cell Transplantation |
| title_full_unstemmed | Graft-Versus-Host Disease Sustains Coagulation Activity for two Years After Pediatric Allogeneic Hematopoietic Stem
Cell Transplantation |
| title_short | Graft-Versus-Host Disease Sustains Coagulation Activity for two Years After Pediatric Allogeneic Hematopoietic Stem
Cell Transplantation |
| title_sort | graft versus host disease sustains coagulation activity for two years after pediatric allogeneic hematopoietic stem cell transplantation |
| url | https://doi.org/10.1177/10760296241304771 |
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