Hematopoietic stem cell transplantation

Graft versus host disease and pathology of gastrointestinal tract, liver, and lung

Neeraja Kambham, John P. Higgins, Uma Sundram, Megan Troxell

Research output: Contribution to journalArticle

22 Citations (Scopus)

Abstract

Hematopoietic stem cell transplantation (HCT), formerly known as bone marrow transplantation, is an integral part of treatment for many hematological malignancies. HCT is associated with several complications and comorbidities with differential effects on a wide spectrum of organs and tissues. We present an update on HCT-associated complications such as graft versus host disease (GVHD) and infection, with focus on the surgical pathology of the gastrointestinal (GI) tract, liver, and lung. Although the grading system for GI tract acute GVHD was proposed 40 years ago, recent studies have shed light on minimal histologic criteria for diagnosis of GVHD, as well as its differential diagnosis, including histologic effects of various medications. GI dysfunction in autologous transplant recipients is increasingly appreciated and patients are often biopsied. Acute liver injury in HCT is often due to sinusoidal obstruction syndrome (previously known as venoocclusive disease), or acute GVHD. Liver dysfunction at later time posttransplantation may be associated with acute or chronic GVHD, iron overload, or other causes of hepatitis. Lung injury in HCT is multifactorial, and it remains crucially important to diagnose and treat pulmonary infections. The pulmonary biopsy yields clinically unsuspected diagnoses in the majority of cases and its utilization is likely to increase. The pathology of the skin and kidney in HCT patients are detailed in accompanying articles.

Original languageEnglish (US)
Pages (from-to)301-320
Number of pages20
JournalAdvances in Anatomic Pathology
Volume21
Issue number5
DOIs
StatePublished - 2014

Fingerprint

Hematopoietic Stem Cell Transplantation
Graft vs Host Disease
Gastrointestinal Tract
Pathology
Lung
Liver
Hepatic Veno-Occlusive Disease
Surgical Pathology
Iron Overload
Autografts
Lung Injury
Acute Disease
Hematologic Neoplasms
Infection
Bone Marrow Transplantation
Hepatitis
Comorbidity
Liver Diseases
Differential Diagnosis
Kidney

Keywords

  • graft versus host disease
  • hematopoietic stem cell transplant
  • sinusoidal obstructionsyndrome
  • thrombotic microangiopathy

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Anatomy
  • Medicine(all)

Cite this

Hematopoietic stem cell transplantation : Graft versus host disease and pathology of gastrointestinal tract, liver, and lung. / Kambham, Neeraja; Higgins, John P.; Sundram, Uma; Troxell, Megan.

In: Advances in Anatomic Pathology, Vol. 21, No. 5, 2014, p. 301-320.

Research output: Contribution to journalArticle

Kambham, Neeraja ; Higgins, John P. ; Sundram, Uma ; Troxell, Megan. / Hematopoietic stem cell transplantation : Graft versus host disease and pathology of gastrointestinal tract, liver, and lung. In: Advances in Anatomic Pathology. 2014 ; Vol. 21, No. 5. pp. 301-320.
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