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Graft-Versus-Host Disease

Chronic intestinal graft-versus-host disease: clinical, histological and immunohistochemical analysis of 17 children

Bone Marrow Transplantation volume 29, pages 223–230 (2002)Cite this article

Abstract

Graft-versus-host disease (GVHD) can be acute or chronic. The pathogenesis of chronic GVHD is unclear. Chronic GVHD affects mainly skin, liver and digestive tract. Intestinal involvement is uncommon and histological features are poorly described. We report here the clinical, histological and immunohistochemical features of chronic GVHD with intestinal involvement. Intestinal biopsies from children with chronic GVHD (n = 17) were compared to control children (n = 21: 10 non-transplant cases, four non-GVHD transplant cases, seven acute GVHD). We evaluated clinical outcome, histological features and characterized immunohistochemically the immune cells involved locally. Chronic GVHD with intestinal involvement was usually multisystemic (88.2%) and preceded by acute GVHD in 88.2% of cases. The outcome was severe with complete recovery in only 58.8% of cases, and death related to chronic GVHD in 17.6% of cases. Histological features were characterized by (1) villous atrophy and (2) glandular lesions, mainly apoptotic with variable intensity and (3) lamina propria infiltrate with cytotoxic T lymphocytes (CD3+, CD8+, TiA1+, granzyme B−) which were significantly (P < 0.001) increased compared to non-GVHD transplant and non-transplant controls. Therefore in chronic intestinal GVHD, the apoptotic process could be related to cytotoxic T lymphocytes.

Bone Marrow Transplantation (2002) 29, 223–230. doi:10.1038/sj.bmt.1703329

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Acknowledgements

The authors thank Martine Grimal for helpful secretariat assistance, Jean-Paul Monnet for preparing the photomicrographs and Olivier Hermine, MD PhD, for his advice and critical review of the manuscript.

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Authors and Affiliations

  1. Department of Pathology and Université René Descartes-Paris V (EA 219), France

    N Patey-Mariaud de Serre, D Reijasse, V Verkarre, D Canioni & N Brousse

  2. Department of Pediatric Gastroenterology and Nutrition (C Ricour), Hôpital Necker-Enfants Malades, Paris, France

    V Colomb

  3. Department of Pediatric Immunology-Hematology (A Fischer), Hôpital Necker-Enfants Malades, Paris, France

    E Haddad

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Patey-Mariaud de Serre, N., Reijasse, D., Verkarre, V. et al. Chronic intestinal graft-versus-host disease: clinical, histological and immunohistochemical analysis of 17 children. Bone Marrow Transplant 29, 223–230 (2002). https://doi.org/10.1038/sj.bmt.1703329

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