Epithelial denudement in the gastrointestinal tracts of two bone marrow transplant recipients

Examination of autopsy specimens from two patients revealed extensive denudement of gastrointestinal (GI) tract epithelium but preservation of basic mucosal structure otherwise. Each patient had received an allogeneic bone marrow transplant for acute leukemia. Although both patients experienced transient episodes of graft-versus-host disease (GVHD), neither experienced significant GI tract symptomatology. The usual explanations for GI epithelial denudement in such patients focus on the mechanisms of accelerated epithelial cell loss. Also considered in these two patients was the possibility that previous treatment(s) had severely interfered with the capacity for epithelial cell renewal. Chemotherapy, total body irradiation, or GVHD, alone or in some combination, may have depleted the stem cell populations and interfered with proliferative epithelial repair.