Graft-versus-host disease confined solely to intestine after allogeneic peripheral blood stem cells transplantation in a patient with chronic myelogenous leukemia.
We describe a patient with chronic myelogenous leukemia who developing severe intestinal bleeding after allogeneic peripheral blood stem cells transplantation (allo-PBSCT). PBSC were obtained from an HLA one-locus mismatch sibling donor. On day 26 after PBSCT, although there was no sign of graft-versus-host disease (GVHD) in either the skin or the liver, diarrhea and severe intestinal bleeding occurred. The histopathological examination of the colon revealed complete denudation of the epithelial cells of the mucosa and no obvious apoptosis. Neither red cell fragments nor hemorrhagic diathesis was seen during this episode and the patient was diagnosed as having GVHD. Methylpredonisolone followed by FK506 may be effective in controlling intestinal bleeding and was used in our patient. Acute GVHD involving only the intestine has rarely been described but when using HLA-mismatched PBSCs, acute GVHD may occur severely and atypically.
Nomura
Kenichi
K
Molocular Hematology and Oncology, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kawaramachi Hirokoji Kamigyo-ku 602-0841 Kyoto Japan. nomuken@sun.kpu-m.ac.jp
Nakao
Mitsushige
M
Matsumoto
Yosuke
Y
Taji
Sawako
S
Yoshida
Naohisa
N
Mitsufuji
Shoji
S
Yokota
Shohei
S
Horiike
Shigeo
S
Okanoue
Takeshi
T
Taniwaki
Masafumi
M
D000208:Acute Disease; D000328:Adult; D006086:Graft vs Host Disease / Q000145:classification* / Q000473:pathology; D006650:Histocompatibility Testing; D006801:Humans; D007410:Intestinal Diseases / Q000209:etiology* / Q000473:pathology; D015464:Leukemia, Myelogenous, Chronic, BCR-ABL Positive / Q000628:therapy*; D008297:Male; D033581:Stem Cell Transplantation / Q000009:adverse effects*; D014184:Transplantation, Homologous; D016896:Treatment Outcome