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Pancreatic atrophy is associated with gastrointestinal chronic GVHD following allogeneic PBSC transplantation

Bone Marrow Transplantation volume 45, pages 590–592 (2010)Cite this article

Despite a curative treatment for hematological malignancy, allo-SCT is associated with many adverse effects in recipients. Weight loss occurs in 20–30% of patients after transplantation and is highly common among those with chronic GVHD (cGVHD).1 The cGVHD scoring system associates severe weight loss with a poor prognosis.1 The etiology of weight loss is not well understood at present, but is suspected to be multifactorial. Possible causes include malabsorption, decreased caloric intake, increased energy expenditure and hypercatabolism.2 Weight loss may be partially due to pancreatic exocrine insufficiency as seen with steatorrhea3, 4 or to gastrointestinal (GI) cGVHD.5 To date, however, few reports have radiographically evaluated the pancreas of patients after SCT.

To evaluate pancreatic atrophy in long-term transplant survivors, we retrospectively reviewed consecutive 42 patients with hematological malignancy after allogeneic PBSCT from related donors at our institution between June 2001 and October 2007. All recipients had chest/abdominal computed tomography (CT) before transplantation. Eligible patients were those with at least 100-days’ survival and had to be available for pancreatic assessment by CT anytime after PBSCT. Of them, 32 patients survived for more than 100 days. Two of the 32 patients were not available for CT assessment after PBSCT, leaving 30 patients eligible. GI involvement of acute GVHD and cGVHD was definitely diagnosed by endoscopic biopsy. Pancreatic atrophy was defined as volume loss of pancreatic appearance on CT compared between pre- and post-PBSCT. Weight loss was defined as the difference between baseline weight at transplantation (day 0±1 week) and minimum documented weight anytime after day 100. Factors for pancreatic atrophy were assessed by entering variables with a P-value of <0.05 into multivariable analysis using a logistic regression model.

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  1. Division of Hematology, Kanto Medical Center, NTT EC, Tokyo, Japan

    H Nakasone, A Ito, H Endo, M Kida, I Koji & K Usuki

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  1. H Nakasone
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  2. A Ito
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  3. H Endo
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  4. M Kida
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  5. I Koji
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  6. K Usuki
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Correspondence to H Nakasone.

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Nakasone, H., Ito, A., Endo, H. et al. Pancreatic atrophy is associated with gastrointestinal chronic GVHD following allogeneic PBSC transplantation. Bone Marrow Transplant 45, 590–592 (2010). https://doi.org/10.1038/bmt.2009.171

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