S3098 Gastrointestinal and Hepatobiliary Complications Following Bone Marrow Transplantation – A Single Center Study

Abstract

INTRODUCTION: Nausea, vomiting, diarrhea and abnormal liver function tests (LFT) are common following both autologous and allogenic bone marrow transplantation (BMT). The incidence and severity of these complications have decreased in the last few years with the use of less intensive chemotherapeutic regimens and better supportive care. Nausea, vomiting, diarrhea or abnormal LFTs can occur due to chemotherapy, infection or graft versus host disease (GVHD). Here we aim to describe gastrointestinal and hepatobiliary complications following BMT at our institution in Philadelphia, PA. METHODS: We conducted a retrospective chart review of patients who presented with nausea, vomiting, diarrhea or abnormal LFTs within 3 months of bone marrow transplantation at our institution between November 1, 2016 and October 31, 2018. Baseline demographics, gastrointestinal complications and liver function test were collected. RESULTS: Fifteen patients underwent bone marrow transplantation between November 1, 2016 and October 31, 2018. Among these patients, nine patients had gastrointestinal complications or transaminitis. The majority of these nine patients were white males. The average age of BMT for patients with complications was 53. Of these nine patients, 7 patients had nausea, vomiting or diarrhea and 3 patients had abnormal LFTs. Only two patients out of 7 patients with diarrhea were positive for Clostridium difficile colitis. Others had diarrhea which was thought to be secondary to regimen related toxicity, and one was from an atypical Crohn’s flare. Abnormal LFTs were thought to be secondary to sepsis or medication-induced. CONCLUSION: More than half of the patients who underwent BMT had gastrointestinal or hepatic complications. Unlike other studies, we did not have any patients with GVHD. However, Clostridium difficile colitis was not uncommon. There were several cases with an unknown etiology. A larger sample size would be helpful in further delineating the incidence and determining trends of various gastrointestinal and hepatobiliary complications following BMT in recent years.Table 1.: Demographics, gastrointestinal complications and laboratory values for patients with bone marrow transplantation.