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Early and late gastrointestinal complications after myeloablative and nonmyeloablative allogeneic stem cell transplantation

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Abstract

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.

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Abbreviations

SCT:

Stem cell transplantation

CT:

Computed tomography

GVHD:

Graft-versus-host disease

CMV:

Cytomegalovirus

GI:

Gastrointestinal

WHO:

World Health Organization

BM:

Bone marrow

PBSC:

Peripheral blood stem cells

G-CSF:

Granulocyte colony-stimulating factor

RBC:

Red blood cells

DNA:

Deoxyribonucleic acid

PBS:

Phosphate-buffered saline

HU:

Hounsfield unit

PCR:

Polymerase chain reaction

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Authors and Affiliations

  1. Bone Marrow Transplantation, Department of Medicine I, University of Vienna, Waehringer Guertel 18–20, 1090, Vienna, Austria

    A. Schulenburg, H. T. Greinix, F. Keil, M. Mitterbauer & P. Kalhs

  2. Department of Radiology, University of Vienna, Vienna, Austria

    K. Turetschek

  3. Department of Pathology, University of Vienna, Vienna, Austria

    F. Wrba

  4. Department of Gastroenterology, University of Vienna, Vienna, Austria

    H. Vogelsang

Authors
  1. A. Schulenburg
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  2. K. Turetschek
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  3. F. Wrba
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  4. H. Vogelsang
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  5. H. T. Greinix
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  6. F. Keil
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  7. M. Mitterbauer
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  8. P. Kalhs
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Schulenburg, A., Turetschek, K., Wrba, F. et al. Early and late gastrointestinal complications after myeloablative and nonmyeloablative allogeneic stem cell transplantation. Ann Hematol 83, 101–106 (2004). https://doi.org/10.1007/s00277-003-0756-4

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  • DOI: https://doi.org/10.1007/s00277-003-0756-4

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