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Histologic analysis has a prognostical value in colorectal biopsies assessed for suspicion of graft-versus-host disease

Authors
  • Sauvestre, Fanny1
  • Belleannée, Geneviève1
  • Bréal, Claire2
  • Mohr, Catherine2
  • Fong, Harold IpKan1
  • Cossin, Sébastien3
  • Tabrizi, Reza2
  • Milpied, Noël2
  • Vigouroux, Stéphane2
  • Goussot, Jean-François1
  • Marty, Marion1
  • 1 University Hospital of Bordeaux, Haut-Lévêque Hospital, Department of Pathology, Avenue de Magellan, Pessac, 33604, France , Pessac (France)
  • 2 University Hospital of Bordeaux, Haut-Lévêque Hospital, Department of Hematology, Pessac, France , Pessac (France)
  • 3 ISPED, Population Health, University of Bordeaux, Bordeaux, France , Bordeaux (France)
Type
Published Article
Journal
Virchows Archiv
Publisher
Springer Berlin Heidelberg
Publication Date
Nov 22, 2017
Volume
472
Issue
2
Pages
213–220
Identifiers
DOI: 10.1007/s00428-017-2272-2
Source
Springer Nature
Keywords
License
Yellow

Abstract

Gastrointestinal (GI) graft-versus-host-disease (GVHD) is a common and severe complication of allogeneic hematopoietic stem cell transplantation, but clinical and histological features are unspecific. The aim of this study was to correlate the histological GI GVHD grade with the clinical outcomes. In a retrospective study of 112 patients with clinically suspected GI GVHD, colonic biopsies were reviewed by three pathologists without knowledge of the corresponding clinical data and classified in four scores, according to the NIH Consensus Project recommendations: no GVHD, possible, probable, and unequivocal GVHD. At the end of the study, the histological and clinical data were confronted with the following results: clinical diagnosis of GI GVHD was established for 70 patients (62.5%) and histological scores correlated well with the clinical diagnosis (p < 0.001) and particularly with the prognosis (p < 0.05).When severe lesions were observed, the 1 year overall survival declined to 9%. None of the features reported in the literature to support GVHD diagnosis, eosinophil count, endocrine cells aggregate, immunohistochemical analysis (cytomegalovirus, CD123, chromogranin), did not help us for diagnosis. So routine histopathology alone without immunohistochemistry is a strong and reproducible tool to diagnose GI GVHD with the help of clinical and biological information, and most importantly, histological grading proved to be a powerful prognostic value.

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