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Related Concept Videos

Bone Marrow Sampling and Transplants01:22

Bone Marrow Sampling and Transplants

Bone marrow transplant is a potential cure for several diseases, including cancer and specific genetic disorders. Notably, this procedure is applicable for patients suffering from aplastic anemia, certain types of leukemia, severe combined immunodeficiency disease (SCID), Hodgkin's disease, non-Hodgkin's lymphoma, multiple myeloma, thalassemia, sickle-cell disease, and certain cancers.
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Quantitative Multispectral Analysis Following Fluorescent Tissue Transplant for Visualization of Cell Origins, Types, and Interactions
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GI complications in pediatric patients post-BMT.

C C Barker1, R A Anderson, R S Sauve

  • 1Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada. cbarker@cw.bc.ca

Bone Marrow Transplantation
|May 24, 2005
PubMed
Summary

Pediatric bone marrow transplant (BMT) recipients frequently experience hepatic and gastrointestinal complications. Graft-versus-host disease (GVHD) and veno-occlusive disease (VOD) significantly impact liver function, while mucositis and diarrhea are common GI issues.

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Area of Science:

  • Pediatric Hematology/Oncology
  • Gastroenterology
  • Transplant Medicine

Background:

  • Bone marrow transplantation (BMT) is a critical treatment for pediatric hematologic malignancies and other diseases.
  • Post-transplant complications, particularly hepatic and gastrointestinal (GI), significantly affect patient outcomes.
  • Understanding the incidence and etiology of these complications is crucial for improving pediatric BMT care.

Purpose of the Study:

  • To comprehensively examine the spectrum and frequency of hepatic and gastrointestinal complications following pediatric BMT.
  • To identify risk factors and potential differentiating markers for specific complications like graft-versus-host disease (GVHD) and veno-occlusive disease (VOD).
  • To assess the impact of these complications on patient morbidity and mortality.

Main Methods:

  • Retrospective study analyzing data from 132 pediatric patients who underwent 142 BMTs.
  • Detailed review of medical records to identify and quantify hepatic and gastrointestinal complications.
  • Statistical analysis to determine the incidence of various complications and their associations.

Main Results:

  • High incidence of hyperbilirubinemia (28%) and clinically evident jaundice (16%).
  • Acute GVHD occurred in 46% of patients, with significant liver (39%) and intestinal (60%) involvement.
  • Veno-occlusive disease (VOD) affected 18% of patients; elevated transaminases were higher in GVHD/VOD.
  • Biliary sludging (20%), mucositis (90%), vomiting (85%), and diarrhea (67%) were common GI issues.
  • Diarrhea etiologies included GVHD (27%), viral infections (6%), C. difficile (8%), and unknown causes (28%).
  • Gastrointestinal bleeding occurred in 8% and was disproportionately linked to ICU admission and 100-day mortality.

Conclusions:

  • Hepatic and gastrointestinal complications are major contributors to morbidity and mortality in pediatric BMT recipients.
  • Serum bilirubin levels may aid in differentiating between VOD and hepatic GVHD.
  • Close monitoring and management of GI and hepatic complications are essential for improving survival rates post-pediatric BMT.