Early and late gastrointestinal complications after myeloablative and nonmyeloablative allogeneic stem cell transplantation.
Upper and lower gastrointestinal symptoms are major and serious complications after stem cell transplantation. Their main causes are gastrointestinal graft-versus-host disease (GVHD), infections, toxicity, or preexisting gastrointestinal diseases. The clinical presentation of each disease is nonspecific. The diagnostic procedure for this study included physical exam, stool cultures, endoscopy with biopsies, and abdominal computed tomography (CT). The study was designed prospectively with consecutive patients and performed at our institution in a clinical stem cell transplantation setting. Between January 1996 and September 2001, we analyzed 42 consecutive patients who had been admitted at our institution for gastrointestinal complaints after allogeneic stem cell transplantation for hematologic diseases. Diagnostic procedures revealed in decreasing order: GVHD (62%), gastritis/esophagitis (19%), cytomegalovirus (CMV) enteritis (11%), bacterial enteritis (6%), and toxic mucosal damage (2%). CT showed unspecific findings. Gastrointestinal GVHD and infectious colitis accounted for the majority of gastrointestinal complications after allogeneic stem cell transplantation in our patient population. The diagnosis was mainly based on endoscopically obtained biopsies.
Schulenburg
A
A
Bone Marrow Transplantation, Department of Medicine I, University of Vienna, Waehringer Guertel 18-20, 1090 Vienna, Austria.
Turetschek
K
K
Wrba
F
F
Vogelsang
H
H
Greinix
H T
HT
Keil
F
F
Mitterbauer
M
M
Kalhs
P
P
D000328:Adult; D000368:Aged; D001424:Bacterial Infections / Q000209:etiology; D016026:Bone Marrow Transplantation / Q000009:adverse effects; D003586:Cytomegalovirus Infections / Q000209:etiology; D005260:Female; D005753:Gastric Mucosa / Q000382:microbiology / Q000473:pathology; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000209:etiology* / Q000473:pathology; D006086:Graft vs Host Disease / Q000209:etiology / Q000473:pathology; D006801:Humans; D007413:Intestinal Mucosa / Q000382:microbiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D011446:Prospective Studies; D033581:Stem Cell Transplantation / Q000009:adverse effects* / Q000379:methods; D019172:Transplantation Conditioning / Q000009:adverse effects*; D014184:Transplantation, Homologous
D019653:Myeloablative Agonists