Disseminated intravascular coagulation in transfusion-associated graft-versus-host disease. Report of two cases

In two cases of transfusion-associated graft-versus-host disease (TA-GVHD), severe bleeding tendencies were observed besides the characteristic features of the disease. An elevation of fibrin degradation products (FDP), D-dimer, thrombin-antithrombin III complex (TAT) and plasmin-alpha 2 plasmin inhibitor complex (PIC), was revealed. These findings were compatible with disseminated intravascular coagulation (DIC). To our knowledge, the association of TA-GVHD and DIC has not been described, and it is our speculation that allogeneic immune reactions may play some pathogenic role in developing DIC in TA-GVHD. The DIC may be responsible for the rapid progression of multiple organ failure (MOF) in TA-GVHD.