Colon biopsies for evaluation of acute graft-versus-host disease (A-GVHD) in allogeneic bone marrow transplant patients

Vinod B. Shidham, Chung Che Chang, Ganesh Shidham, Farrukh Ghazala, Paul F. Lindholm, Bal Kampalath, Varghese George, Richard Komorowski

Research output: Contribution to journalArticle

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Abstract

Background: Proper histomorphological interpretation of intestinal acute graft versus host disease (A-GVHD) associated with allogeneic bone marrow transplantation (BMT) is critical for clinical managaement. However, studies methodically evaluating different histomorphological features of A-GVHD are rare. Methods: Colonic biopsies from 44 allogeneic BMT patients having biopsy-proven cutaneous A-GVHD were compared with colon biopsies from 48 negative controls. Results: A-GVHD showed intra-cryptal apoptosis in 91% and pericryptal apoptosis in adjacent lamina propria in 70% (p < 0.002). Nonspecific apoptosis along the surface epithelium was observed in all groups with comparable frequency. The number of apoptotic cells in mucosa were approximately four times (5.3 per 10 HPF) the negative controls (p < 0.002) in A-GVHD group. 48% of cases with A-GVHD showed decreased number of lymphocytes in lamina propria. Some features, including intraepithelial lymphocytes in surface or crypt epithelium; and neutrophils, eosinophils, and edema in lamina propria, did not demonstrate significant difference in A-GVHD and negative controls. Pericryptal apoptosis, dilated crypts, irregular distribution of crypts, decreased lymphocytes, increased microvessel network, focal fibrosis, presence of muciphages, reactive changes in surface epithelium with mucin depletion, mucosal ulceration, and/or reduced mucosal thickness showed higher association with A-GVHD group. Conclusions: Intracyptal apoptosis is a reliable indicator of A-GVHD. Its diagnostic significance was improved if intracyptal apoptosis was associated with features which were observed more frequently in A-GVHD group as mentioned above.

Original languageEnglish (US)
Article number5
JournalBMC Gastroenterology
Volume3
DOIs
StatePublished - Mar 27 2003

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Graft vs Host Disease
Colon
Bone Marrow
Transplants
Biopsy
Apoptosis
Mucous Membrane
Epithelium
Homologous Transplantation
Bone Marrow Transplantation
Lymphocytes
Lymphocyte Count
Mucins
Microvessels
Eosinophils
Edema
Neutrophils
Fibrosis
Cell Count
Skin

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Shidham, V. B., Chang, C. C., Shidham, G., Ghazala, F., Lindholm, P. F., Kampalath, B., ... Komorowski, R. (2003). Colon biopsies for evaluation of acute graft-versus-host disease (A-GVHD) in allogeneic bone marrow transplant patients. BMC Gastroenterology, 3, [5]. https://doi.org/10.1186/1471-230X-3-5

Colon biopsies for evaluation of acute graft-versus-host disease (A-GVHD) in allogeneic bone marrow transplant patients. / Shidham, Vinod B.; Chang, Chung Che; Shidham, Ganesh; Ghazala, Farrukh; Lindholm, Paul F.; Kampalath, Bal; George, Varghese; Komorowski, Richard.

In: BMC Gastroenterology, Vol. 3, 5, 27.03.2003.

Research output: Contribution to journalArticle

Shidham, Vinod B. ; Chang, Chung Che ; Shidham, Ganesh ; Ghazala, Farrukh ; Lindholm, Paul F. ; Kampalath, Bal ; George, Varghese ; Komorowski, Richard. / Colon biopsies for evaluation of acute graft-versus-host disease (A-GVHD) in allogeneic bone marrow transplant patients. In: BMC Gastroenterology. 2003 ; Vol. 3.
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AU - Chang, Chung Che

AU - Shidham, Ganesh

AU - Ghazala, Farrukh

AU - Lindholm, Paul F.

AU - Kampalath, Bal

AU - George, Varghese

AU - Komorowski, Richard

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AB - Background: Proper histomorphological interpretation of intestinal acute graft versus host disease (A-GVHD) associated with allogeneic bone marrow transplantation (BMT) is critical for clinical managaement. However, studies methodically evaluating different histomorphological features of A-GVHD are rare. Methods: Colonic biopsies from 44 allogeneic BMT patients having biopsy-proven cutaneous A-GVHD were compared with colon biopsies from 48 negative controls. Results: A-GVHD showed intra-cryptal apoptosis in 91% and pericryptal apoptosis in adjacent lamina propria in 70% (p < 0.002). Nonspecific apoptosis along the surface epithelium was observed in all groups with comparable frequency. The number of apoptotic cells in mucosa were approximately four times (5.3 per 10 HPF) the negative controls (p < 0.002) in A-GVHD group. 48% of cases with A-GVHD showed decreased number of lymphocytes in lamina propria. Some features, including intraepithelial lymphocytes in surface or crypt epithelium; and neutrophils, eosinophils, and edema in lamina propria, did not demonstrate significant difference in A-GVHD and negative controls. Pericryptal apoptosis, dilated crypts, irregular distribution of crypts, decreased lymphocytes, increased microvessel network, focal fibrosis, presence of muciphages, reactive changes in surface epithelium with mucin depletion, mucosal ulceration, and/or reduced mucosal thickness showed higher association with A-GVHD group. Conclusions: Intracyptal apoptosis is a reliable indicator of A-GVHD. Its diagnostic significance was improved if intracyptal apoptosis was associated with features which were observed more frequently in A-GVHD group as mentioned above.

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