fibrin and Graft-vs-Host-Disease

Mesenchymal stem cells (MSCs) have been used systemically or locally in many chronic and nonhealing skin lesions in recent years. In this study, umbilical cord-derived MSCs (UC-MSCs)-seeded fibrin matrix was used as a wound dressing in pediatric patients with stage 4 acute graft-versus-host disease (aGVHD)-induced desquamated skin lesions. This is the first study in which the UC-MSCs-seeded fibrin matrix was used as a wound dressing in aGVHD. A total of 14 times the MSCs-seeded fibrin matrix were applied to 9 patients as a wound dressing. On the seventh day, epithelialization and clinical response were evaluated. According to the size of the skin defect min: 1, max: 6 pieces were applied at a time. After 48 to 72 hours, it was observed that all of the MSCs-seeded fibrin matrixes adhered to the skin and the crustation started in 6 (43%) applications, whereas liquefaction was detected under all of them in 7 (50%) applications. Complete response was obtained in 6 applications (43%), partial response in 1 (7%), and no response in 7 applications (50%). This study showed that the MSCs-seeded fibrin matrix can be used effectively and safely in the matrix in the local treatment of aGVHD-induced skin wounds in pediatric patients.

Topics: Adolescent; Bandages; Cells, Cultured; Child; Child, Preschool; Female; Fibrin; Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Humans; Infant; Male; Mesenchymal Stem Cell Transplantation; Mesenchymal Stem Cells; Prospective Studies; Skin; Tissue Scaffolds; Umbilical Cord; Wound Healing

To describe an unusual ocular manifestation of a patient with acute myeloid leukemia (AML).. Observational case report.. A 59-year-old woman with a history of preleukemic myelodysplastic syndrome (MDS) and status post bone marrow transplant (BMT) complained of a sudden onset of poor vision associated with a corneal pseudomembrane. Ocular graft vs host disease was suspected, and the pseudomembrane was excised for histopathologic examination.. The pseudomembrane showed myeloblasts admixed with an acute inflammatory response suggestive of the development of AML, a complication of MDS. Bone marrow examination confirmed the diagnosis of relapsing AML.. Acute myeloid leukemia could present as a pseudomembrane; thus, examination of relevant ocular tissue is recommended.

Topics: Acute Disease; Bone Marrow; Bone Marrow Transplantation; Corneal Diseases; Female; Fibrin; Graft vs Host Disease; Humans; Leukemia, Myeloid; Membranes; Middle Aged; Neoplasm Recurrence, Local

Hemostatic parameters were examined in 39 patients who underwent allogeneic bone marrow transplantation (BMT). Twenty-six patients survived and 13 patients died within 6 months after BMT. The main causes of death were acute graft-versus-host disease (GVHD: n=6), veno-occlusive disease (VOD: n=2), and thrombotic microangiopathy (TMA: n=2). Plasma levels of D-dimer and thrombomodulin (TM) were significantly elevated in the non-survivor group. Plasma levels of soluble fibrin (SF) and Fas were significantly elevated in the non-survivor group at 1 to 4 weeks after BMT. Plasma levels of thrombin-antithrombin complex (TAT), D-dimer, and tissue plasminogen activator-plasminogen activator inhibitor-1 complex (tPA-PAI-1 complex) were significantly elevated in patients with complications after BMT. Plasma levels of TAT, D-dimer, and tPA-PAI-1 complex were significantly elevated in patients with GVHD. These results suggest that abnormalities of hemostatic parameters might predict poor outcomes or complications in patients with BMT.

Topics: Adolescent; Adult; Biomarkers; Blood Coagulation Factors; Bone Marrow Transplantation; Cause of Death; fas Receptor; Female; Fibrin; Follow-Up Studies; Graft vs Host Disease; Hematologic Neoplasms; Hemostasis; Humans; Male; Middle Aged; Predictive Value of Tests; Prognosis; Transplantation, Homologous; Vascular Diseases

Host-versus-graft (HVG) disease is the fatal result of the allogenic reaction which occurs in parental strain mice perinatally inoculated with F(1) hybrid spleen cells. The principal manifestations of the syndrome in RFM/(T(6) X RFM)F(1) mice are thrombocytopenia, intestinal hemorrhage, hepatic necrosis, lymphoproliferative disorders and renal disease due to immune complexes. The discovery of intravascular fibrin deposits in the present studies establishes disseminated intravascular coagulation (DIC) as an intermediary mechanism of HVG disease. It is suggested that the characteristic declines in blood platelet levels, intestinal hemorrhages and hepatic infarcts are triggered principally by immune complexes. Cellular infiltrates of the liver, granulocytosis and hypergammaglobulinemia are other abnormalities which are regularly found in HVG mice and which are also thought to predispose to DIC.

Topics: Animals; Antigen-Antibody Complex; Blood Vessels; Chimera; Disseminated Intravascular Coagulation; Fibrin; Graft vs Host Disease; Hybridization, Genetic; Immunoglobulin G; Infarction; Injections, Intraperitoneal; Kidney; Leukocyte Count; Liver; Mice; Mice, Inbred Strains; Mosaicism; Proteinuria; Spleen; Thrombocytopenia