Destruction of the Intestinal Mucosa after Bone Marrow Transplantation and Graft-versus-Host Disease

Beschorner, William E.

doi:10.1159/000156931

Cited by 7 publications

(4 citation statements)

References 22 publications

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“…Involvement of the gastrointestinal tract (GI) usually appears after a skin rash and rarely is the presenting or sole manifestation [3,9,10]. Diarrhea, lower GI bleeding, infection, and infarction all may develop and are significant causes of morbidity and mortality [7,11].…”

Section: Discussionmentioning

confidence: 99%

Rectal inflammation as first manifestation of graft-vs-host disease: radiologic-pathologic findings

et al. 2003

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Graft-vs-host disease (GVHD) is a common, life-threatening complication of bone marrow transplantation that frequently involves the gastrointestinal tract. Since symptoms are typically nonspecific, radiologic examination is often performed to reach a diagnosis. To the best of our knowledge, this is the first reported radiologic description of a case of rectal involvement as the first manifestation of GVHD. The differential diagnosis of segmental rectal wall thickening in a patient following bone marrow transplantation should include GVHD.

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Section: Discussionmentioning

confidence: 99%

Rectal inflammation as first manifestation of graft-vs-host disease: radiologic-pathologic findings

et al. 2003

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“…Findings in chronic GVHD of the gut, while generally similar to those in acute GVHD, may be less frequent ( 11 , 13 ). Gastrointestinal GVHD and its treatment, together with associated superinfection, act to impair mucosal integrity and immunity ( 53 ), leading to imaging signs such as bowel wall thickening. These signs may be related to GVHD or have other etiologies ( 11 ).…”

Section: Figurementioning

confidence: 99%

“…Organ (gut) grading was based on modifi ed Glucksberg grading system ( 6 ). Histopathologic severity was assessed in terms of crypt atrophy by using a four-point scale ( 53 ). a = Correlates with overall clinical grading, b = correlates with gut grading, and c = correlates with pathologic grading.…”

Section: Figurementioning

confidence: 99%

Radiologic Imaging and Intervention for Gastrointestinal and Hepatic Complications of Hematopoietic Stem Cell Transplantation

Mahgerefteh

Sosna²,

Bogot³

et al. 2011

Radiology

100

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Hematopoietic stem cell transplantation (HSCT) is an increasingly available treatment option for patients with various oncologic, hematologic, and immunologic diseases. Although HSCT can be curative for some diseases, complications associated with this treatment limit its success and applicability. Gastrointestinal graft-versus-host disease (GVHD) and hepatic veno-occlusive disease are unique and deadly complications of HSCT. These diseases can mimic other HSCT complications, such as infection, hemorrhage, and hepatotoxicity with cholestasis, but GVHD and veno-occlusive disease require specific treatment. Early treatment improves the probability of treatment success. For these reasons, timely and accurate diagnosis is essential. Abdominal imaging and intervention play an important role in the early, minimally invasive diagnosis and treatment of GVHD and veno-occlusive disease. Imaging findings tend to be nonspecific, but common findings that may guide further management or establish a diagnosis in the clinical setting have been defined. In cases where the diagnosis is unclear and liver biopsy is required, image-guided transvenous liver biopsy may be a safer and more practical option than the transcutaneous approach. Image-guided interventions, including intraarterial steroid-injection therapy in severe, systemic steroid-refractory GVHD and transjugular intrahepatic portosystemic shunt placement in veno-occlusive disease with portal hypertension, have shown some promise in small, uncontrolled series. Larger, controlled studies are needed to define the role of these invasive procedures in this patient population.

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“…Viral hepatitis may be caused by different agents (B, ~, non-A, non-B), and its incidence in these patients may be over 40%, owing to the extreme immune suppression and to blood transfusions [255]. The histological differentiation between hepatic GvHD and non-A non-B hepatitis is often difficult [256,257]. In a recent study on 186 patients, actuarial survival was not significantly better in patients with normal as opposed to abnormal transaminases pre-transplant.…”

Section: Liver Complicationsmentioning

confidence: 99%

Bone Marrow Transplantation

Marmont¹

1990

New Approaches to the Treatment of Leukemia

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Destruction of the Intestinal Mucosa after Bone Marrow Transplantation and Graft-versus-Host Disease

Cited by 7 publications

References 22 publications

Rectal inflammation as first manifestation of graft-vs-host disease: radiologic-pathologic findings

Rectal inflammation as first manifestation of graft-vs-host disease: radiologic-pathologic findings

Radiologic Imaging and Intervention for Gastrointestinal and Hepatic Complications of Hematopoietic Stem Cell Transplantation

Bone Marrow Transplantation

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