JPGN reports · 6 authors, 3 centres
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This retrospective cohort study of 57 pediatric HSCT recipients at two Latin American centers found that GI GVHD commonly presents with diarrhea and abdominal pain, that endoscopic and histological severity classifications were discordant, and that overall mortality was 26%.
This retrospective observational study included 57 pediatric patients with confirmed intestinal or hepatic GVHD after HSCT at two Latin American centers between January 2007 and January 2017. Of the cohort, 74% had GI GVHD, 11% liver GVHD, and 15% liver-intestinal involvement. Diarrhea (96%) and abdominal pain (55%) were the most frequent symptoms. Endoscopies were performed in 88% of GI GVHD cases, with 35% requiring a second procedure; normal-appearing mucosa was observed in 17% of upper GI endoscopies and 29% of colonoscopies. No direct relationship was observed between endoscopic and histological classification. Overall mortality was 26%, with infectious complications most common. A decrease in nutritional status was observed from transplantation to GVHD diagnosis. The retrospective design is acknowledged as the most important limitation, introducing risk of bias especially in clinical parameters.
