Serum Tumor Marker CA 125 Is an Early and Sensitive Marker for Veno-Occlusive Disease in Children Undergoing Bone Marrow Transplantation:

Abstract 881 Hematology-Oncology II Poster Symposium, Sunday, 5/2 Veno-occlusive disease (VOD) is a serious complication of patients undergoing bone marrow transplantation (BMT). The diagnosis of VOD is currently based on clinical signs and unspecific laboratory findings. CA 125 is an oncofetal antigen used as a tumor marker in various malignancies, especially in those originating from the female reproductive tract or gastrointestinal organs but its level is not increased in hematological malignancies. Since CA 125 is expressed also in normal peritoneum, we hypothesized that peritoneal irritation in VOD would cause serum CA 125 levels to increase. The study included 179 serum samples from twenty nine children undergoing BMT for various indications. There were 14 girls and 15 boys whose mean age was 6.2 years (range 0.1 to 17.2 years). Eight patients (28%) developed clinical VOD 6 to 30 days (mean 18 days) after BMT and a significant increase in serum CA 125 was noted in all of them. During up to 7 days before the diagnosis of VOD, an increase of at least 57 % in serum CA 125 from the pre-BMT value was observed in 6 out of 7 (86%) of the evaluable patients with VOD. In contrast, a similar increase in the 21 non-VOD patients was noted in only 6 patients before the 30th post-BMT day. Thus, the sensitivity and specificity of serum CA 125 for predicting or detecting VOD were 86 % and 71 %, respectively. The serum levels of CA 125 were not affected by the presence of a systemic, septic infection. In conclusion, serum CA 125 is of value as an early marker of VOD in children undergoing BMT.