Serum procollagen type III is an early and sensitive marker for veno-
occlusive disease of the liver in children undergoing bone marrow
transplantation
M Heikinheimo, R Halila and A Fasth
Children's Hospital, University of Helsinki, Finland.
Veno-occlusive disease of the liver (VOD) is a life-threatening
complication occurring in patients undergoing bone marrow transplantation
(BMT). Although clinical signs and laboratory parameters such as elevation
of serum bilirubin often suggest this condition, it would be useful to
identify early biochemical markers for VOD. Fibrous alterations in the
hepatic venules and small lobular veins occur during development of VOD;
these changes are accompanied by the deposition of types I and III collagen
in the liver tissue. Since the N- terminal propeptide of type III
procollagen (PIIINP) is a sensitive marker of liver and lung fibrosis, we
undertook a study to evaluate the usefulness of measurements of serum
PIIINP in children with VOD. Seven of the 28 children who underwent BMT,
both allogenic and autologous, developed VOD. All seven had an increase of
more than 100 ng/mL in the serum PIIINP level, whereas only one of the
remaining 21 children not affected by VOD had an increment of PIIINP more
than 100 ng/mL (P = .0001). The levels of serum PIIINP were higher in the
VOD group during the follow-up period of up to 91 days after BMT. The
elevation of PIIINP also occurred at a stage of the disease usually
preceding any other laboratory or clinical signs of VOD. Serum
concentration of PIIINP thus seems to be of value as an early marker for
VOD in children undergoing BMT.
Volume 83,
Issue 10,
pp. 3036-3040,
05/15/1994
Copyright © 1994 by The American Society of Hematology
