Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0018133 (graft-versus-host disease)
 18,032 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We are reporting on a 25 years old patient with acute myelogenous leukemia, who developed an acute graft-versus-host disease (GVHD) 43 days after allogeneic bone marrow transplantation (BMT). The clinical symptoms included exanthema, diarrhea and abdominal cramps. The patient was treated with cyclosporine A and prednisone and the clinical symptoms disappeared subsequently. At day 225 post BMT the patient became icteric as the clinical manifestation of chronic GVHD. We describe in this case report endoscopical and histological findings during the episodes of acute and chronic graft-versus-host disease. The results obtained by sigmoidoscopy and liver biopsy confirmed the clinical diagnosis. The clinical work up of patients with acute or/and chronic GVHD should also include sigmoidoscopy in order to verify this transplantation related complication.
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PMID:[Gastroenterologic findings in graft versus host disease after allogenic bone marrow transplantation]. 192 62

Graft-versus-host disease (GVHD) is one of the life-threatening complications of allogeneic bone marrow transplantation; it is probably due to an immunological reaction mounted by engrafted lymphocytes against the host. Symptoms of involvement of the gastrointestinal tract in GVHD are abdominal cramps and diarrhea, accompanied by a variety of functional derangements. The histologic changes, most marked in the ileum and colon, consist of necrosis of crypt epithelium leading to glandular depopulation. The radiographic features in the small intestine were studied in 7 patients with gastrointestinal GVHD. Characteristic was the disappearance of mucosal folds in a substantial part of the small bowel, most marked distally. Furthermore, there was thickening of the bowel wall and a very rapid transit of contrast material. The findings are compared with findings in the literature.
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PMID:Radiographic features of small intestinal injury in human graft-versus-host disease. 703 21

Xerostomia due to chronic graft-versus-host disease (GVHD) or total-body irradiation (TBI) is an important cause of morbidity after BMT. The ophthalmic or oral form of pilocarpine, a parasympathomimetic agent with predominantly muscarinic activity, was given orally to 13 patients with moderate (n = 6) or severe (n = 7) xerostomia due to chronic GVHD (n = 7) or TBI (n = 6). The duration of 19 courses of therapy was 7-245 days (median 73). Ten patients (77%) noticed significant improvement in salivation and relief of symptoms which reached its maximum after 7-186 days (median 46). Difficulty in eating and speaking reduced, and there was a beneficial effect on the oral mucosa and teeth. Xerophthalmia improved in one of six patients. Five patients had adverse reactions: wheezing (n = 1), and increased sweating without (n = 3) or with (n = 1) abdominal cramps (n = 1): leading to discontinuation of pilocarpine in one. Three patients stopped pilocarpine, became symptomatic again, but the benefits were reproducible on restarting pilocarpine. The ophthalmic preparation was as effective as the oral, and was one-tenth the cost of the oral. We conclude that oral pilocarpine is effective in relieving xerostomia associated with chronic GVHD and TBI. The time taken for a response to be seen is variable, and unless significant adverse effects are encountered, pilocarpine should be continued for 6-8 weeks before it is considered to have failed.
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PMID:Pilocarpine hydrochloride for symptomatic relief of xerostomia due to chronic graft-versus-host disease or total-body irradiation after bone-marrow transplantation for hematologic malignancies. 908 44

We describe a 25-year-old patient suffering from vaginal outflow obstruction which presented as secondary amenorrhea during hormone replacement therapy. The patient had undergone bone marrow transplantation for acute myelocytic leukemia, which caused ovarian failure. Oral mucositis associated with a chronic GVH reaction also occurred. For 3 years she was treated with HRT and had regular menses which gradually ceased and were associated with dyspareunia and abdominal cramps. Abdominal US examination demonstrated hematocolpus. Sonography guided adhesiolysis of a dense vaginal obstruction allowed free drainage with histologic confirmation of a graft-versus-host reaction. The possibility of vaginal stricture or obstruction should be considered in all patients after BMT who suffer from graft-versus-host disease.
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PMID:Vaginal outflow tract obstruction by graft-versus-host reaction. 1051 88

Current treatment of chronic graft-versus-host disease (cGVHD) with prednisone (PSE) alone or with added cyclosporine or tacrolimus still has a very high failure and complication rate, and new treatment approaches are needed for both primary and salvage therapy. Mycophenolate mofetil (MMF) is an immunosuppressive agent currently in use for acute graft-versus-host disease prophylaxis. To determine whether MMF had activity in the treatment of cGVHD, we added MMF to standard cyclosporine, tacrolimus, and/or PSE as salvage/second-line (n = 24) or first-line (n = 10) therapy in 34 patients. Nine (90%) of 10 patients receiving first-line and 18 (75%) of 24 receiving second-line MMF therapy responded. Twelve (35%) patients had a complete remission, 15 (44%) had a partial remission, 5 (15%) had stable disease, and only 2 (6%) had progressive disease. Out of 30 patients receiving PSE, 22 (73%) were able to decrease PSE doses (median decrease of 50%; range, 25%-100%). With a median follow-up of 24 months (range, 6-28 months), 29 (85%) patients are alive. Three patients had to discontinue MMF because of abdominal cramps within 3 months of starting treatment. These data suggest that MMF is an active, well-tolerated agent in the treatment of cGVHD and may have a beneficial effect on the survival of patients with this complication.
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PMID:Efficacy of mycophenolate mofetil in the treatment of chronic graft-versus-host disease. 1581 96

We present a patient with acute myelogenous leukemia who developed severe acute intestinal graft versus host disease (GVHD) after donor lymphocyte infusion (DLI) following non-myeloablative allogeneic peripheral blood stem cell transplantation (allo-PBCT). One month after DLI, patient developed severe abdominal cramps, watery diarrhea without any signs or symptoms of the skin and liver GVHD. Treatment with steroid, cyclosporine A, tacrolimus and mycophenolat mofetil were not effective in controlling intestinal symptoms. Extracorporeal photochemotherapy (ECP), a recently used procedure in the treatment of GVHD was employed periodically and the symptoms subsided gradually. Acute GVHD after DLI may occur severely and atypically, but being limited to the intestine has rarely been reported.
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PMID:Severe intestinal graft versus host disease after donor lymphocyte infusion; response to extracorporeal photochemotherapy. 1615 Jun 45