Abstract
Gastrointestinal and hepatic complications are common in the hematopoietic stem cell transplant (HSCT) patient. The agents used in the conditioning regimen induce direct disruption of the intestinal barrier as well as indirect damage from cytokine release and generalized inflammatory state. These events lead to permeation of bacteria and endotoxins through the bowel wall, with subsequent organ damage and increased risk for infections. Similarly, HSCT conditioning can directly affect the hepatic parenchyma or hepatic sinusoids. The immunosuppressed state of the HSCT patient also increases the risk for opportunistic infections of the gastrointestinal tract and liver.
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References
Barker, C., Anderson, R., Sauve, R., Butzner, J. (2005). GI complications in pediatric patients post-BMT. Bone Marrow Transplant, 36(1):51–58.
Bresters, D., Van Gils, I., Dekker, F., Lankester, A., Bredius, R., Schweizer, J. (2008). Abnormal liver enzymes 2 years after haematopoietic stem cell transplantation in children: Prevalence and risk factors. Bone Marrow Transplant, 41(1):27–31.
Cox, G., Matsui, S., Lo, R., Hinds, M., Bowden, R., Hackman, R., et al. (1994). Etiology and outcome of diarrhea after marrow transplantation; a prospective study. Gastroenterology, 107(5):1398–1407.
Crouch, M., Restino, M., Cruz, J., Perry, J., Hurd, D. (1996). Octreotide acetate in refractory bone marrow transplant-associated diarrhea. Ann Pharmacothera, 30(4):331–336.
Firpi, R., Nelson, D. (2006). Viral hepatitis: Manifestations and management strategy. Hematology Am Soc Hematol Educ Program, 375–380.
Geller, R., Gilmore, C., Dix, S., Lin, L., Topping, D., Davidson, T., et al. (1995). Randomized trial of loperimide versus dose escalation of octreotide acetate for chemotherapy-induced diarrhea in bone marrow transplant and leukemia patients. Am J Hematol, 50(3):167–172.
Ho, V., Revta, C., Richardson, P. (2008). Hepatic veno-occlusive disease after hematopoietic stem cell transplantation: Update on defibrotide and other current investigational therapies. Bone Marrow Transplant, 41(3):229–237.
Ippoliti, C., Champlin, R., Bugazia, N., Przepiorka, D., Neumann, J., Giralt, S., et al. (1997). Use of octreotide in the symptomatic management of diarrhea induced by graft-versus-host disease in patients with hematologic malignancies. J Clin Oncol, 5(11):3350–3354.
Johansson, J., Abrahamsson, H., Ekman, T. (2003). Gastric emptying after autologous hematopoietic stem cell transplantation: A prospective trial. Bone Marrow Transplant, 32(8):815–819.
Ko, C., Gooley, T., Schoch, H., Myerson, D., Hackman, R., Shulman, H., et al. (1997). Acute pancreatitis in marrow transplant patients: Prevalence at autopsy and risk factor analysis. Bone Marrow Transplant, 20(12):1081–1086.
Malone, F., Leisenring, W., Storer, B. L., Stern, J., Bouvier, M., Martin, P., et al. (2007). Prolonged anorexia and elevated plasma cytokine levels following myeloablative allogeneic hematopoietic cell transplant. Bone Marrow Transplant, 40(8):765–772.
Murray, S., Pindoria, S. (2009, January 21). Nurtrition support for bone marrow transplant patients. Retrieved from mrw.interscience.wiley.com: CD002920.
Sakai, M., Strasser, S., Shulman, H., McDonald, S., Schoch, H., McDonald, G. (2009). Severe hepatocellular injury after hematopoietic stem cell transplant: Incidence, etiology and outcome. Bone Marrow Transplant, 44(7):441–447.
Schulenburg, A., Turetschedk, K., Wrba, F., Vogelsang, H., Greinix, H., Keil, F., et al. (2004). Early and late gastrointestinal complications after myeloablative and nonmyeloablative allogeneic stem cell transplantation. Ann Hematol, 83(2):101–106.
Schwartz, J., Wolford, J., Thornquist, M., Hockenbery, D., Murakami, C., Drennan, F., et al. (2001). Severe gastrointestinal bleeding after hematopoietic stem cell transplantation, 1987–1997: Incidence, causes, and outcome. Am J Gastroenterol, 96(2):385–393.
Teefey, S., Hollister, M., Lee, S., Jacobson, A., Higano, C., Bianco, J., et al. (1994). Gallbladder sludge formation after bone marrow transplant: Sonographic observations. Abdom Imaging, 19(1):57–60.
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Nemecek, E. (2010). Gastrointestinal Complications. In: Maziarz, R., Slater, S. (eds) Blood and Marrow Transplant Handbook. Springer, New York, NY. https://doi.org/10.1007/978-1-4419-7506-5_18
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DOI: https://doi.org/10.1007/978-1-4419-7506-5_18
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