Severe intestinal graft versus host disease after donor lymphocyte infusion; response to extracorporeal photochemotherapy.
We present a patient with acute myelogenous leukemia who developed severe acute intestinal graft versus host disease (GVHD) after donor lymphocyte infusion (DLI) following non-myeloablative allogeneic peripheral blood stem cell transplantation (allo-PBCT). One month after DLI, patient developed severe abdominal cramps, watery diarrhea without any signs or symptoms of the skin and liver GVHD. Treatment with steroid, cyclosporine A, tacrolimus and mycophenolat mofetil were not effective in controlling intestinal symptoms. Extracorporeal photochemotherapy (ECP), a recently used procedure in the treatment of GVHD was employed periodically and the symptoms subsided gradually. Acute GVHD after DLI may occur severely and atypically, but being limited to the intestine has rarely been reported.
Vural
Filiz
F
Medical Faculty, Department of Hematology, Ege University, 35100 Bornova, Izmir, Turkey. fivural@yahoo.com
Donmez
Ayhan
A
Doganavşargil
Başak
B
Cagýrgan
Seçkin
S
Alper
Hüdaver
H
Tombuloglu
Murat
M
D003967:Diarrhea / Q000209:etiology / Q000473:pathology / Q000628:therapy; D006086:Graft vs Host Disease / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods; D006801:Humans; D007410:Intestinal Diseases / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000628:therapy*; D017710:Lymphocyte Transfusion / Q000379:methods; D008297:Male; D008875:Middle Aged; D017893:Photopheresis / Q000379:methods; D014184:Transplantation, Homologous