Abstract
Gastrointestinal graft-versus-host disease (GVHD) and cytomegalovirus (CMV) disease are common complications occurring after allogeneic hematopoietic stem cell transplantation (allo-HSCT), and contribute to a high degree of morbidity and mortality associated with allo-HSCT. Herein, we present a patient with severe intestinal GVHD complicated by recurring CMV enteritis, which overall resulted in severe terminal ileum stenosis. The patient underwent laparoscopic ileocecal resection that significantly reduced symptoms and possibly prevented the development of fulminant ileus. Surgical treatment is rarely used in the treatment of gastrointestinal GVHD; however, the current patient history illustrates that patients with inadequate symptom control and severe inflammatory bowel stenosis can be successfully managed with surgery. We also review published case reports on surgical treatment for severe gastrointestinal GVHD.
Highlights
Graft-versus-host disease (GVHD) is a severe complication seen after allogeneic hematopoietic stem cell transplantation [1,2]
GVHD has been treated with immunosuppressive agents such as cyclosporine, corticosteroids, tacrolimus, or mycophenolate mofetil [3]
After three cycles of 5-azacitidine, the patient achieved reduction in blast count to
Summary
Graft-versus-host disease (GVHD) is a severe complication seen after allogeneic hematopoietic stem cell transplantation (allo-HSCT) [1,2]. Immunosuppressive therapy in GVHD increases the risk of infectious complications [6], especially cytomegalovirus (CMV) reactivation or primary CMV disease [7]. With regular monitoring for CMV and pre-emptive treatment, severe CMV disease are seldom observed [7]. Recurrent CMV disease in the GI-tract, such as CMV enteritis, can be severe and may require long-term antiviral treatment that is often associated with side effects requiring prolonged hospitalization [7]. We present a patient with severe and obstructive bowel pathology after allo-HSCT, where surgical intervention was considered the only option for treatment of the patient’s symptoms and a review of the literature regarding surgical treatment of GI-tract complications after allo-HSCT
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
