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

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.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