Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Post-Transplant Complications

Clinical features and treatment of hematopoietic stem cell transplantation-associated gastric antral vascular ectasia

Bone Marrow Transplantation volume 32, pages 417–421 (2003)Cite this article

Summary:

Gastric antral vascular ectasia (GAVE) may occur after hematopoietic stem cell transplantation (HSCT) and cause severe and prolonged gastric bleeding. The underlying pathology of transplant-associated GAVE (HSCT-GAVE) is poorly understood and an effective therapeutic strategy has not been established yet. We retrospectively reviewed the medical records of 230 consecutive allogeneic transplant recipients in our institution between January 1997 and June 2002. We identified five patients who developed HSCT-GAVE (2.2%). Four patients had bleeding from HSCT-GAVE and one patient had HSCT-GAVE discovered incidentally. The clinical features of these patients were similar in that they all received conditioning treatment with busulfan and had history of thrombotic microangiopathy. Furthermore, treatment with a beta-blocker apparently improved the outcome of HSCT-GAVE in three patients.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Singh C, McDonald GB . Intestinal and hepatic complications of bone marrow and stem cell transplantation. In: Taylor MB, Gollan JL, Steer ML, Wolfe MM (eds). Gastrointestinal Emergencies. Williams & Wilkins: Baltimore, 1997, pp 1–21.

    Google Scholar 

  2. Marmaduke DP, Greenson JK, Cunningham I et al. Gastric vascular ectasia in patients undergoing bone marrow transplantation. Am J Clin Pathol 1994; 102: 194–198.

    Article  CAS  Google Scholar 

  3. Tobin RW, Hackman RC, Kimmey MB et al. Bleeding from gastric antral vascular ectasia in marrow transplant patients. Gastrointest Endosc 1996; 44: 223–229.

    Article  CAS  Google Scholar 

  4. Burak KW, Lee SS, Beck PL . Portal hypertensive gastropathy and gastric antral vascular ectasia (GAVE) syndrome. Gut 2001; 49: 866–872.

    Article  CAS  Google Scholar 

  5. Gostout CJ, Viggiano TR, Ahlquist DA et al. The clinical and endoscopic spectrum of the watermelon stomach. J Clin Gastroenterol 1992; 15: 256–263.

    Article  CAS  Google Scholar 

  6. McDonald GB, Hinds MS, Fisher LD et al. Veno-occlusive disease of the liver and multiorgan failure after bone marrow transplantation: a cohort study of 355 patients. Ann Intern Med 1993; 118: 255–267.

    Article  CAS  Google Scholar 

  7. Westaby D, Bihari DJ, Gimson AE et al. Selective and non-selective beta receptor blockade in the reduction of portal pressure in patients with cirrhosis and portal hypertension. Gut 1984; 25: 121–124.

    Article  CAS  Google Scholar 

  8. Gostout CJ, Ahlquist DA, Radford CM et al. Endoscopic laser therapy for watermelon stomach. Gastroenterology 1989; 96: 1462–1465.

    Article  CAS  Google Scholar 

  9. Bjorkman DJ, Buchi KN . Endoscopic laser therapy for watermelon stomach. Laser Surg Med 1992; 12: 478–481.

    Article  CAS  Google Scholar 

  10. Sanaka M, Kuyama Y, Shimomura Y et al. Gastric emptying of liquids is delayed by co-ingesting solids: a study using salivary paracetamol concentrations. J Gastroenterol 2002; 37: 785–790.

    Article  CAS  Google Scholar 

  11. Buggia I, Locatelli F, Regazzi MB, Zecca M . Busulfan. Ann Pharmacother 1994; 28: 1055–1062.

    Article  CAS  Google Scholar 

  12. Yeager AM, Wagner Jr JE, Graham ML et al. Optimization of busulfan dosage in children undergoing bone marrow transplantation: a pharmacokinetic study of dose escalation. Blood 1992; 80: 2425–2428.

    CAS  Google Scholar 

  13. Catani L, Gugliotta L, Vianelli N et al. Endothelium and bone marrow transplantation. Bone Marrow Transplant 1996; 17: 277–280.

    CAS  Google Scholar 

  14. Vincent C, Pomier-Layrargues G, Dagenais M et al. Cure of gastric antral vascular ectasia by liver transplantation despite persistent portal hypertension: A clue for pathogenesis. Liver Transplant 2002; 8: 717–720.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Hematology Division, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

    K Ohashi, Y Tanaka, S Mori, H Akiyama & H Sakamaki

  2. Gastroenterology Division, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

    M Sanaka, Y Tu & N Egawa

  3. Pathology Division, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

    K Ohashi & N Funata

  4. Blood Transfusion Service, Tokyo Metropolitan Komagome Hospital, Tokyo, Japan

    Y Okuyama & K Hiruma

Authors
  1. K Ohashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M Sanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Y Tu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. N Egawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. K Ohashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. N Funata
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Y Okuyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. K Hiruma
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Y Tanaka
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. S Mori
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. H Akiyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. H Sakamaki
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ohashi, K., Sanaka, M., Tu, Y. et al. Clinical features and treatment of hematopoietic stem cell transplantation-associated gastric antral vascular ectasia. Bone Marrow Transplant 32, 417–421 (2003). https://doi.org/10.1038/sj.bmt.1704137

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1704137

Keywords

This article is cited by

Search

Advanced search

Quick links