Chronic graft versus host disease with small bowel obstruction after unrelated hematopoietic stem cell transplantation in a patient with acute myeloid leukemia

Ju Young Yoon; Hyery Kim; Hyoung Jin Kang; Kyung Duk Park; Hee Young Shin; Hyo Seop Ahn

doi:10.5045/kjh.2012.47.2.142

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Korean J Hematol 2012; 47(2):

Published online June 26, 2012

https://doi.org/10.5045/kjh.2012.47.2.142

Chronic graft versus host disease with small bowel obstruction after unrelated hematopoietic stem cell transplantation in a patient with acute myeloid leukemia

Ju Young Yoon, Hyery Kim, Hyoung Jin Kang, Kyung Duk Park, Hee Young Shin^*, and Hyo Seop Ahn

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Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.

Correspondence to : Correspondence to Hee Young Shin, M.D., Ph.D. Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul 110-799, Korea. Tel: +82-2-2072-2917, Fax: +82-2-3675-0999, hyshin@snu.ac.kr

Received: September 7, 2011; Revised: October 7, 2011; Accepted: February 20, 2012

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

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Abstract

Chronic graft versus host disease (GVHD) is a frequent complication after allogeneic hematopoietic stem cell transplantation (HSCT), but simultaneous small bowel obstruction is rare. Here, we report a child with acute myeloid leukemia who received an allogeneic HSCT from an unrelated matched donor. After HSCT, the patient developed severe chronic GVHD involving the small intestine, leading to obstruction of the terminal ileum. Small bowel resection was performed, and the symptoms improved without severe complications. Bowel obstruction should be considered as a possible complication of chronic GVHD; surgery may be a valuable corrective measure.

Keywords Acute myeloid leukemia, Hematopoietic stem cell transplantation, Graft versus host disease, Intestinal obstruction

Article

Case Report

Korean J Hematol 2012; 47(2): 142-145

Published online June 26, 2012 https://doi.org/10.5045/kjh.2012.47.2.142

Chronic graft versus host disease with small bowel obstruction after unrelated hematopoietic stem cell transplantation in a patient with acute myeloid leukemia

Ju Young Yoon, Hyery Kim, Hyoung Jin Kang, Kyung Duk Park, Hee Young Shin^*, and Hyo Seop Ahn

Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.

Correspondence to:Correspondence to Hee Young Shin, M.D., Ph.D. Department of Pediatrics, Cancer Research Institute, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, Seoul 110-799, Korea. Tel: +82-2-2072-2917, Fax: +82-2-3675-0999, hyshin@snu.ac.kr

Received: September 7, 2011; Revised: October 7, 2011; Accepted: February 20, 2012

Abstract

Keywords: Acute myeloid leukemia, Hematopoietic stem cell transplantation, Graft versus host disease, Intestinal obstruction

Abstract

Fig 1.

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Figure 1.

Chest CT image obtained on day 138 shows multifocal subsegmental atelectasis and increased interstitial marking.

Blood Research 2012; 47: 142-145https://doi.org/10.5045/kjh.2012.47.2.142

Fig 2.

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Figure 2.

Ten hours after upper GI contrast study on day 264. Luminal narrowing of the small bowel with dilatation of the proximal bowel can be seen.

Blood Research 2012; 47: 142-145https://doi.org/10.5045/kjh.2012.47.2.142

Fig 3.

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Figure 3.

Surgical specimen showing a segment of the small bowel. Diffuse constriction of the muscle layer is observed in the terminal ileum. The length of the obstructed segment is approximately 15 cm.

Blood Research 2012; 47: 142-145https://doi.org/10.5045/kjh.2012.47.2.142