İntestinal graft versus host hastalığının endoskopik bulgularının retrospektif değerlendirilmesi

Abstract

Background and Aims: Acute graft-versus-host disease occurs after allogeneic hematopoietic stem cell transplantation and is a reaction of donor immune cells against host tissues. Activated donor T cells damage host epithelial cells. About 35%-50% of hematopoietic stem cell transplant recipients will develop acute graft-versus-host disease. The endoscopic findings varied markedly and included mild mucosal edema with focal erythema, diffuse erythema, and diffuse polypoid indurations with multiple bleeding ulcerations. We investigated endoscopic findings in a graft-versus-host disease patient population. Materials and Methods: A retrospective review of endoscopic data was performed in 18 adult allogeneic bone marrow transplant recipients at our institution. Results: In this study, 18 allogeneic bone marrow transplant patients (mean age 33.9 years; 62% male) were evaluated. In 6 graftversus- host disease patients, the endoscopic appearances of the esophagus, stomach and duodenum varied from subtle mucosal erythema and edema to frank ulceration. Colonoscopy was performed with biopsies in 12 graft-versus- host disease patients. The colonoscopic findings varied markedly and ranged from mild mucosal edema with focal erythema to multiple bleeding ulcerations. Conclusions: The diagnostic accuracy of endoscopy was high in gastrointestinal graft-versus-host disease. Accurate diagnosis of gastrointestinal graft-versus-host disease might be obtained with mucosal biopsies from either the upper or lower gastrointestinal tract. Endoscopy may play a significant role in establishing early diagnosis and treatment for gastrointestinal graft-versus-host disease patients.