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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, Geneviève2
  • Bréal, Claire3
  • Mohr, Catherine3
  • Fong, Harold IpKan2
  • Cossin, Sébastien4
  • Tabrizi, Reza3
  • Milpied, Noël3
  • Vigouroux, Stéphane3
  • Goussot, Jean-François2
  • Marty, Marion2
  • 1 Department of Pathology, University Hospital of Bordeaux, Haut-Lévêque Hospital, Avenue de Magellan, 33604, Pessac, France. [email protected] , (France)
  • 2 Department of Pathology, University Hospital of Bordeaux, Haut-Lévêque Hospital, Avenue de Magellan, 33604, Pessac, France. , (France)
  • 3 Department of Hematology, University Hospital of Bordeaux, Haut-Lévêque Hospital, Pessac, France. , (France)
  • 4 ISPED, Population Health, University of Bordeaux, Bordeaux, France. , (France)
Type
Published Article
Journal
Virchows Archiv : an international journal of pathology
Publication Date
Feb 01, 2018
Volume
472
Issue
2
Pages
213–220
Identifiers
DOI: 10.1007/s00428-017-2272-2
PMID: 29167990
Source
Medline
Keywords
License
Unknown

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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