title: Improvement of inflammatory bowel disease after allogeneic stem-cell transplantation.
abstract: Because causes of inflammatory bowel disease (IBD) remain obscure and a curative therapy is still lacking, the influence of stem-cell transplantation (SCT) on IBD is of major interest. We retrospectively analyzed the course of seven patients with Crohn's disease and four patients with idiopathic ulcerative colitis who underwent allogeneic SCT between July 1994 and August 2002 for acute and chronic myeloid leukemia and myelodysplastic syndrome. After a median follow-up of 34 months posttransplantation, 10 patients are alive. None of the patients showed IBD activity after SCT, except one patient with mild persistent symptoms of Crohn's disease early after transplant. Colonoscopy after complete discontinuation of prophylactic posttransplant immunosuppression revealed no pathologic findings. These observations imply that host immune dysregulation plays a central role in the perpetuation of IBD. It may be influenced by the implementation of a new allogeneic immune system resulting from the transplantation of hematopoietic stem cells.
authors.affiliation: Klinik für Knochenmarktransplantation, Universitätsklinikum Essen, Essen, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Ditschkowski
authors.forename: Hermann
authors.initials: H
authors.lastname: Einsele
authors.forename: Rainer
authors.initials: R
authors.lastname: Schwerdtfeger
authors.forename: Donald
authors.initials: D
authors.lastname: Bunjes
authors.forename: Rudolf
authors.initials: R
authors.lastname: Trenschel
authors.forename: Dietrich W
authors.initials: DW
authors.lastname: Beelen
authors.forename: Ahmet H
authors.initials: AH
authors.lastname: Elmaagacli
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D003093:Colitis, Ulcerative / Q000150:complications / Q000503:physiopathology; D003424:Crohn Disease / Q000150:complications / Q000503:physiopathology; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000473:pathology / Q000503:physiopathology*; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000150:complications* / Q000601:surgery*; D007951:Leukemia, Myeloid / Q000150:complications* / Q000601:surgery*; D008297:Male; D012189:Retrospective Studies; D033581:Stem Cell Transplantation; D014184:Transplantation, Homologous; D016896:Treatment Outcome