A prospective study of screening upper gastrointestinal (GI) endoscopy prior to and after bone marrow transplantation (BMT).
BACKGROUND
Upper gastrointestinal (GI) endoscopic abnormalities are common in symptomatic bone marrow transplant (BMT) recipients but the incidence of occult gastrointestinal disease in these patients is unknown.


OBJECTIVE
To examine the role of screening upper GI endoscopy before and after BMT.


METHODS
Endoscopy was performed routinely on allogeneic (n = 24) and autologous (n = 17) BMT patients before transplant and at 30 and 120 days after transplant.


RESULTS
Twenty-one of 41 patients (51%) had an endoscopic abnormality on one or more occasions which necessitated a change in treatment. These abnormalities were present in ten of 41 (24%) pre-transplant endoscopies, ten of 32 (31%) endoscopies at day 30 after BMT, and in seven of 22 (32%) day 120 endoscopies. Abnormalities included mucosal erosions or ulcers n = 22 endoscopies), infections (n = 5) or previously undiagnosed GI graft-versus-host disease (n = 3). Mucosal erosions or ulcers were present in eight of 28 endoscopies despite regular anti ulcer drug therapy.


CONCLUSIONS
Screening upper GI endoscopy before and after BMT is generally safe and detects a high yield of significant GI abnormalities. However, it remains to be demonstrated that treatment of these lesions will improve the clinical outcome in BMT recipients without GI symptoms.
Forbes
G M
GM
Department of Gastroenterology, Royal Perth Hospital, WA.
Rule
S A
SA
Herrmann
R P
RP
Davies
J M
JM
Collins
B J
BJ
D000328:Adult; D016026:Bone Marrow Transplantation / Q000009:adverse effects*; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000175:diagnosis; D011446:Prospective Studies; D014182:Transplantation, Autologous; D014184:Transplantation, Homologous