title: Post-transplant gastric antral vascular ectasia after intra-venous busulfan regimen.
abstract: Gastric antral vascular ectasia (GAVE) is an angiodysplastic disorder that causes gastric bleeding. GAVE can develop as a complication of hematopoietic stem cell transplantation (HSCT-GAVE), and it has been suggested that it may be associated with oral administration of busulfan. We report two cases of HSCT-GAVE after a conditioning regimen containing intra-venous busulfan (ivBu), not oral busulfan. The first case, a 42-year-old woman with blastic plasmacytoid dendritic cell neoplasm, underwent second allogeneic HSCT with conditioning regimen consisting of cyclophosphamide (120 mg/kg) and ivBu (12.8 mg/kg). HSCT-GAVE developed on day 84 post-transplant, and argon plasma coagulation (APC) was performed successfully. The second case, a 60-year-old woman with acute myelogenous leukemia, underwent allogeneic HSCT with the conditioning regimen consisting of ivBu (12.8 mg/kg) and fludarabine (150 mg/kg). She developed melena and was diagnosed with GAVE by endoscopy on day 145 post-transplant. Although complete hemostasis was not achieved despite four administrations of APCs, the melena spontaneously terminated on day 235 post-transplant. To our knowledge, this is the first report describing HSCT-GAVE after ivBU-based HSCT. Although there is no established therapy for HSCT-GAVE, APC may be an option for HSCT-GAVE.
authors: Department of Hematology, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki, Japan.
authors: Kuniyoshi
authors: K
authors: Fukuda
authors: Naoki
authors: N
authors: Kurita
authors: Tatsuhiro
authors: T
authors: Sakamoto
authors: Hidekazu
authors: H
authors: Nishikii
authors: Yasushi
authors: Y
authors: Okoshi
authors: Masato
authors: M
authors: Sugano
authors: Shigeru
authors: S
authors: Chiba
mesh_terms: D000328:Adult; D057908:Argon Plasma Coagulation; D002066:Busulfan / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D020252:Gastric Antral Vascular Ectasia / Q000139:chemically induced* / Q000601:surgery; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007262:Infusions, Intravenous; D008875:Middle Aged; D019653:Myeloablative Agonists / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D019172:Transplantation Conditioning / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D019653:Myeloablative Agonists; D002066:Busulfan
references: Am J Clin Pathol. 1994 Aug;102(2):194-8
references: 7986265
references: Bone Marrow Transplant. 2006 Jan;37(2):191-7
references: 16284614
references: Bone Marrow Transplant. 2003 Aug;32(4):417-21
references: 12900779
references: Pediatr Transplant. 2005 Dec;9(6):788-91
references: 16269052
references: Digestion. 2009;79(3):143-50
references: 19329853
references: Endoscopy. 2004 Jan;36(1):68-72
references: 14722858
references: Gastrointest Endosc. 1996 Sep;44(3):223-9
references: 8885337