Gastroparesis following bone marrow transplantation

Area of Science:

• Gastroenterology
• Hematology
• Transplantation Medicine

Background:

• Nausea, vomiting, and bloating are common post-bone marrow transplantation (BMT), impacting nutrition and medication adherence.
• Gastroparesis is a known cause of these symptoms in general patients, but its prevalence and characteristics after BMT are less understood.

Purpose of the Study:

• To investigate the incidence and potential causes of gastroparesis in patients undergoing BMT.
• To assess the efficacy of prokinetic agents in managing BMT-associated gastroparesis symptoms.

Main Methods:

• A retrospective review of 151 BMT patients from January 1996 to March 1997.
• Gastric emptying studies (scintigraphy) and esophagastroduodenoscopy with biopsy were performed on symptomatic patients.
• Comparison of symptomatic patients with asymptomatic BMT recipients.

Main Results:

• 12% of BMT patients developed symptoms suggestive of gastroparesis.
• 14 of 18 symptomatic patients showed delayed gastric emptying, with most responding to prokinetic agents.
• Allogeneic BMT recipients had a significantly higher risk (26%) compared to autologous recipients (0%).

Conclusions:

• Gastroparesis is a frequent complication after allogeneic BMT, contributing to post-transplant gastrointestinal distress.
• Prokinetic agents are effective in managing BMT-associated gastroparesis.
• Graft-versus-host disease and cytomegalovirus infection were not major contributors to gastroparesis in this cohort.