Endothelial dysfunction after bone marrow transplantation: increase of soluble thrombomodulin and PAI-1 in patients with multiple transplant-related complications.

Multiple transplant-related complications (MTRC) represent a severe condition after bone marrow transplantation (BMT) and are supposed to reflect systemic endothelial damage. Soluble thrombomodulin (sTM) and plasminogen activator inhibitor type-1 (PAI-1) were investigated as markers of endothelial dysfunction in 35 patients after autologous or allogeneic BMT and compared with the occurrence of the typical complications sepsis, veno-occlusive disease of the liver (VOD), graft-versus-host disease (GVHD), and capillary leakage syndrome (CLS). PAI-1 was assessed by an assay of functional activity and sTM by antigenic determination.

Thrombocytopenia and complement activation under recombinant TNF alpha/IFN gamma therapy in man.

Infusions of recombinant human tumor necrosis-alpha plus recombinant human interferon-gamma (rhTNF alpha/rhIFN gamma) were assessed in two patients with Ewing's sarcoma. We analyzed platelet count, coagulation and the terminal complement complex (TCC). During cycles with continuous rhTNF alpha-infusions we found a rapid, marked decrease of platelet count (minus 90% of initial values) and a simultaneous increase of TCC (plus 84% of initial values) at day 4.

Generation of the complement activation product C5a precedes interleukin-2-induced capillary leakage syndrome.

Capillary leakage syndrome (CLS) is a severe side effect of intravenous interleukin-2 (IL-2) therapy. Twenty-seven cycles of IL-2 therapy [six (day 1), nine (day 2), and 12 >( 10(6) U/m(2) body surface (days 3 to 5), given as continuous infusion] were analyzed in children and adolescents. The anaphylatoxin C5a was assessed as an early predictor for CLS.

Definition of a new score for severity of generalized Neisseria meningitidis infection.

Neisseria meningitidis infection may present as meningitis or as severe, fulminant sepsis. In order to classify individual patients early according to the expected course of the disease, we developed a score named Neisseria sepsis index [NESI]. The NESI was defined using the parameters heart rate, mean arterial blood pressure, base excess and presence of acute subcutaneous bleeding and/or skin necroses (minimal value [= no evidence for sepsis] NESI 0; maximum value [= most severe sepsis] NESI 8).