Gastrointestinal emergencies in patients with acute intestinal graft-versus-host disease

被引：22

作者：

Chirletti, P ^{[1
]}

Caronna, R ^{[1
]}

Arcese, W ^{[1
]}

Iori, AP ^{[1
]}

Calcaterra, D ^{[1
]}

Cartoni, C ^{[1
]}

Sammartino, P ^{[1
]}

Stipa, V ^{[1
]}

机构：

[1] Univ Rome La Sapienza, I-00161 Rome, Italy

来源：

LEUKEMIA & LYMPHOMA | 1998年 / 29卷 / 1-2期

关键词：

bone marrow transplant; intestinal graft-versus-host-disease; surgical treatment complications;

D O I：

10.3109/10428199809058388

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Acute intestinal graft-versus-host disease (GVHD) develops in about 30-50% of allogeneic bone-marrow transplant recipients: 10-20% have gastrointestinal emergencies (hemorrhage or perforation). Mortality reaches 30-60% in patients with acute, grade 2-4 GVHD. We studied 36 bone marrow recipients in whom acute intestinal GVHD developed. Seven had gastrointestinal emergencies: 4 severe gastrointestinal bleeding and 3 acute peritonitis. Three patients with gastrointestinal bleeding and one patient with peritonitis responded to medical therapy. Three needed surgery: one with bleeding and two with peritonitis, while 1 patient had embolization. Of the 7, two patients died, one after embolization and one after surgery. Two of the three surgically-treated cases an still alive several years after operation. From this experience we feel that surgery for gastrointestinal bleeding in acute GVHD is indicated only when medical treatment fails. Severe neutropenia, thrombocytopenia (<10.000 x mm(3)) and blood cultures positive for CMV have an unfavorable prognostic value.

引用

页码：129 / 137

页数：9

共 47 条

[31] GRAFT VERSUS HOST REACTION IN MAN AFTER BONE-MARROW TRANSPLANTATION-PATHOLOGY, PATHOGENESIS, CLINICAL FEATURES, AND IMPLICATION [J].