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

• Yoon JY
• Kim H
• Kang HJ
• Park KD
• Shin HY
• Ahn HS

• KMID: 2083609
• DOI: http://doi.org/10.5045/kjh.2012.47.2.142

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.

Keyword

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

MeSH Terms

Child
Graft vs Host Disease
Hematopoietic Stem Cell Transplantation
Hematopoietic Stem Cells
Humans
Ileum
Intestinal Obstruction
Intestine, Small
Leukemia, Myeloid, Acute
Tissue Donors
Transplants

Figure

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  Fig. 1 Chest CT image obtained on day 138 shows multifocal subsegmental atelectasis and increased interstitial marking.

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  Fig. 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.

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  Fig. 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.

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  Fig. 4 Pathological images are consistent with chronic GVHD (H&E staining).

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