Gastrointestinal Complications after Allogeneic Hematopoietic Stem Cell Transplant: A Multidisciplinary Approach with Early Endoscopic Evaluation
SC Ematologia A.S.U. Ospedale Maggiore, Trieste, Italy
- https://doi.org/10.2991/chi.k.210826.001How to use a DOI?
- Gastro-intestinal complications (GICs) in allogeneic hematopoietic stem cell transplant (allo-HSCT); graft-versus-host-disease (GVHD); mucositis; endoscopy; intestinal histology
Gastrointestinal complications (GICs) represent the major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Differential diagnosis of GICs is of paramount importance since early and reliable identification of graft-versus-host disease (GVHD) is essential for a correct management of the patients. The aim of the present retrospective study was to evaluate the occurrence of GICs after allo-HSCT and to assess the diagnostic performance of a quick endoscopic and histological assessment in the differential diagnosis between GVHD and other GI conditions. Between January 2015 and August 2019, 122 consecutive patients receiving an allo-HSCT were managed by an interdisciplinary team, supported by a dedicated endoscopic service. Clinical, therapeutic, endoscopic and histological data were analyzed for each patient. Collectively, 94 of the patients developed GICs (77%). A moderate–severe mucositis was the most frequent complication, occurring in 79 patients (84%). Acute GI-GVHD was diagnosed in 35 patients (37% of whom with GICs) and 19 of them with a moderate–severe grade. Infective acute colitis developed in eight patients, mainly due to Clostridium difficile (CD) and Cytomegalovirus infections (8.5%). Rectal biopsy showed the highest sensitivity and specificity (80% and 100%, respectively). However, when biopsy procedures were guided by symptoms and performed on apparently intact mucosa, upper histology also provided a high negative predictive value (80%). Our multidisciplinary approach with a quick endoscopic/histologic investigation in the patients receiving an allo-HSCT and who suffered GICs could improve diagnostic and therapeutic management in this challenging setting.
- © 2021 International Academy for Clinical Hematology. Publishing services by Atlantis Press International B.V.
- Open Access
- This is an open access article distributed under the CC BY-NC 4.0 license (http://creativecommons.org/licenses/by-nc/4.0/).
Cite this article
TY - JOUR AU - Giuseppe Tarantino AU - Francesco Saraceni AU - Giorgia Mancini AU - Monica Poiani AU - Luca Maroni AU - Gaia Goteri AU - Ilaria Scortechini AU - Alessandro Fiorentini AU - Maria Vittoria Dubbini AU - Francesco Marini AU - Luigi Daretti AU - Marco Marzioni AU - Emanuele Bendia AU - Antonio Benedetti AU - Attilio Olivieri PY - 2021 DA - 2021/09/23 TI - Gastrointestinal Complications after Allogeneic Hematopoietic Stem Cell Transplant: A Multidisciplinary Approach with Early Endoscopic Evaluation JO - Clinical Hematology International SP - 161 EP - 168 VL - 3 IS - 4 SN - 2590-0048 UR - https://doi.org/10.2991/chi.k.210826.001 DO - https://doi.org/10.2991/chi.k.210826.001 ID - Tarantino2021 ER -