Serum KL-6 Levels in Patients With Pulmonary Complications After Allogeneic Bone Marrow Transplantation |
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Authors: | Takashi Ashida Masaki Higashishiba Yoshiyasu Sumimoto Tetsuaki Sano Hajime Miyazato Takahiro Shimada Junichi Miyatake Kazunobu Kawanishi Yoichi Tatsumi Akihisa Kanamaru |
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Institution: | (1) Third Department of Internal Medicine, Kinki University School of Medicine, Osaka, Japan;(2) Third Department of Internal Medicine, Kinki University School of Medicine, 377-2, Ohnohigashi, Osaka-Sayama, 589-0014 Osaka, Japan |
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Abstract: | KL-6, a mucinous high—molecular weight glycoprotein expressed on type 2 pneumocytes, has been shown to be elevated in the
serum and bronchoalveolar lavage fluid of patients with interstitial pneumonitis (IP). We measured the serum levels of KL-6
in patients after they had undergone allogeneic bone marrow transplantation (BMT) to determine whether KL-6 could be a clinically
useful indicator for the development of IP. The serum concentrations of KL-6 were determined by a sandwichtype enzyme-linked
immunosorbent assay using an anti—KL-6 monoclonal antibody. A total of 1028 samples were tested from 76 patients (78 transplantations)
who received BMTs. The KL-6 values were markedly elevated in patients with pulmonary complications, but not in those with
acute and chronic graft-versus-host disease, hemorrhagic cystitis, herpes encephalitis, sepsis, and veno-occlusive disease.The
serum levels of KL-6 from patients with pulmonary complications were significantly higher than from those without pulmonary
complications (P < .001) and those with other complications (P < .001). Of the 12 patients with pulmonary complications, 6 had idiopathic IP (IIP). The levels were not high at the onset
of IIP. Four of 6 IIP patients showed marked elevations of KL-6 levels in parallel with the severity of IP and died of respiratory
failure without response to treatment.Assessment of serum KL-6 levels might not be useful for the early diagnosis of IP, but
may be a useful indicator for monitoring the severity of IP after BMT. |
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Keywords: | KL-6 Bone marrow transplantation Interstitial pneumonia |
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