Diagnosis and evaluation of intestinal graft-versus-host disease after allogeneic hematopoietic stem cell transplantation following reduced-intensity and myeloablative conditioning regimens

Satoshi Yamasaki, Akiko Miyagi-Maeshima, Yasuo Kakugawa, Yoshihiro Matsuno, Fusako Ohara-Waki, Shigeo Fuji, Yuriko Morita-Hoshi, Masakazu Mori, Sung Won Kim, Shin Ichiro Mori, Takahiro Fukuda, Ryuji Tanosaki, Tadakazu Shimoda, Kensei Tobinai, Daizo Saito, Yoichi Takaue, Takanori Teshima, Yuji Heike

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2 Citations (Scopus)

Abstract

Colonoscopic evaluation of mucosal tissues after allogeneic hematopoietic stem cell transplantation (HSCT) is very useful in evaluating pathogenesis and diagnosis of intestinal graft-versus-host disease (GVHD). However, information on the timing and sites of biopsies and the immunohistological evaluation of mucosal tissues for diagnosing intestinal GVHD, especially following reduced-intensity (RIC) regimens, remains very limited. A total of 33 patients with histologically proven GVHD after allogeneic HSCT with RIC (n = 23) and myeloablative conditioning (MAC, n = 10) regimens were enrolled in the present study. Colonoscopy was performed due to gastrointestinal symptoms, especially diarrhea and anorexia. Sites of biopsies with the worst histopathological grading were the terminal ileum in 67 % of patients. In the RIC group, the onset of diarrhea prior to colonoscopy examination was later (median: RIC, 57 vs. MAC, 27 days) and the number of patients who developed abdominal pain tended to be higher (RIC, 70 % vs. MAC, 30 %). A lower number of CD4+ cells and a higher ratio of Foxp3+ cells to CD4+ cells were detected in the involved lesions of intestinal GVHD following RIC. These differences in the RIC and MAC groups suggest that regimen-specific therapeutic strategies are required for diagnosing intestinal GVHD.

Original languageEnglish
Pages (from-to)421-426
Number of pages6
JournalInternational journal of hematology
Volume97
Issue number3
DOIs
Publication statusPublished - 2013 Mar 1
Externally publishedYes

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Keywords

  • Allogeneic hematopoietic stem cell transplantation
  • Colonoscopy
  • HLA-matched donor
  • Intestinal graft-versus-host disease
  • Reduced-intensity regimen

ASJC Scopus subject areas

  • Hematology

Cite this

Yamasaki, S., Miyagi-Maeshima, A., Kakugawa, Y., Matsuno, Y., Ohara-Waki, F., Fuji, S., Morita-Hoshi, Y., Mori, M., Kim, S. W., Mori, S. I., Fukuda, T., Tanosaki, R., Shimoda, T., Tobinai, K., Saito, D., Takaue, Y., Teshima, T., & Heike, Y. (2013). Diagnosis and evaluation of intestinal graft-versus-host disease after allogeneic hematopoietic stem cell transplantation following reduced-intensity and myeloablative conditioning regimens. International journal of hematology, 97(3), 421-426. https://doi.org/10.1007/s12185-013-1297-9