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Patterns and Grading of Gastrointestinal Graft-Versus-Host Disease: A Clinicopathologic Correlation Study

Volume 34 · Issue 5 Publish Date: May 15, 2023
Sonay Kuş Öztürk Ayça Kırmızı Nermin Aras Cevriye Cansız Ersöz Meltem Kurt Yüksel Elif Ünal İnce Berna Savaş Mehmet Ertem Aydan Kansu Hülya Çetinkaya Arzu Ensari
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Turkish Journal of Gastroenterology

Volume 34 · Issue 5

Pages: 516-524

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Published Online: May 15, 2023

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This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright © 2023 Sonay Kuş Öztürk, Ayça Kırmızı, Nermin Aras, Cevriye Cansız Ersöz, Meltem Kurt Yüksel, Elif Ünal İnce, Berna Savaş, Mehmet Ertem, Aydan Kansu, Hülya Çetinkaya, Arzu Ensari

Sonay Kuş Öztürk
Department of Pathology, Ankara University Faculty of Medicine, Sıhhıye, Ankara, Turkey
Ayça Kırmızı
Department of Pathology, Ankara University Faculty of Medicine, Sıhhıye, Ankara, Turkey
Nermin Aras
Department of Pathology, Ankara University Faculty of Medicine, Sıhhıye, Ankara, Turkey
Cevriye Cansız Ersöz
Department of Pathology, Ankara University School of Medicine, Ankara, Turkey
Meltem Kurt Yüksel
Department of Hematology, Ankara University School of Medicine, Ankara, Turkey
Elif Ünal İnce
Department of Pediatric Hematology, Ankara University Faculty of Medicine, Sıhhıye, Ankara, Turkey
Berna Savaş
Departments of Pathology and Gastroenterology, Ankara University School of Medicine, Ankara
Mehmet Ertem
Department of Pediatric Hematology, Ankara University Faculty of Medicine, Sıhhıye, Ankara, Turkey
Aydan Kansu
AÜTF Pediatrik Gastroenteroloji Bilim Dalı, Ankara
Hülya Çetinkaya
Departments of Gastroenterology Ankara University
Arzu Ensari
Departments of Gastroenterology Pathology Ankara University
Kuş Öztürk, S., Kırmızı, A., Aras, N., Cansız Ersöz, C., Kurt Yüksel, M., Ünal İnce, E., … Ensari, A. (2023). Patterns and Grading of Gastrointestinal Graft-Versus-Host Disease: A Clinicopathologic Correlation Study. Turkish Journal of Gastroenterology, 34(5), 516–524. https://doi.org/10.5152/tjg.2023.22012
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Abstract

Background: The present study investigated gastrointestinal involvement patterns of acute graft-versus-host disease and assessed the correlation of pathologic severity with clinical grading. Methods: Pathology reports of gastrointestinal (GI) endoscopic biopsies taken from 164 post-hematopoietic stem cell transplant patients with at least 1 endoscopic gastrointestinal biopsy diagnosed as “consistent with acute graft-versus-host disease” between 2005 and 2019 were retrieved from the automated hospital database. Endoscopic, pathologic and clinical gradings were performed using Freiburg criteria, Lerner and modified Seattle-Glucksberg grading systems, respectively. Results: The majority of the patients (n = 140, 85.4%) were investigated with more than one biopsy from various gastrointestinal sites with a total of 479 biopsies: 44 (9.2%) esophagus, 90 (18.8%) stomach, 91 (19.0%) duodenum, 20 (4.2%) terminal ileum, 32 (6.7%) right colon, 87 (18.2%) left colon and, 115 (23.9%) rectum. Overall, lower gastrointestinal (n = 118/126, 93.6%) and upper gastrointestinal (n = 91/97, 93.8%) involvements were similar (P = .3). While the most severely affected site was duodenum (P = .021) in upper gastrointestinal, pathologic grades were similar in lower gastrointestinal sites, though more severe than upper gastrointestinal (P = .003). Pathologic grading had a low positive correlation with both clinical (r = 0.308, P = .001) and endoscopic grading (coefficient: 0.261, P = .003). Conclusion: Considering the similar graft-versus-host disease frequency of upper and lower gastrointestinal tract, distal colon evaluation with rectosigmoidoscopy seems to be a practical approach in patients with suspected gastrointestinal graft-versus-host disease. As it was positively correlated with both endoscopic and clinical grade, pathologic grading should be performed in these patients to assess gastrointestinal involvement patterns. Cite this article as: Kuş Öztürk S, Kırmızı A, Aras N, et al. Patterns and grading of gastrointestinal graft-versus-host disease: A clinicopathologic correlation study. Turk J Gastroenterol. 2023;34(5):516-524.

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Article Info
Published In
Journal Turkish Journal of Gastroenterology
Volume / Issue Volume 34 · Issue 5
Pages 516-524
DOI 10.5152/tjg.2023.22012
History
Published Online May 15, 2023
License
Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright
Copyright (c) 2023 Sonay Kuş Öztürk, Ayça Kırmızı, Nermin Aras, Cevriye Cansız Ersöz, Meltem Kurt Yüksel, Elif Ünal İnce, Berna Savaş, Mehmet Ertem, Aydan Kansu, Hülya Çetinkaya, Arzu Ensari
Affiliations
Sonay Kuş Öztürk
Department of Pathology, Ankara University Faculty of Medicine, Sıhhıye, Ankara, Turkey
Ayça Kırmızı
Department of Pathology, Ankara University Faculty of Medicine, Sıhhıye, Ankara, Turkey
Nermin Aras
Department of Pathology, Ankara University Faculty of Medicine, Sıhhıye, Ankara, Turkey
Cevriye Cansız Ersöz
Department of Pathology, Ankara University School of Medicine, Ankara, Turkey
Meltem Kurt Yüksel
Department of Hematology, Ankara University School of Medicine, Ankara, Turkey
Elif Ünal İnce
Department of Pediatric Hematology, Ankara University Faculty of Medicine, Sıhhıye, Ankara, Turkey
Berna Savaş
Departments of Pathology and Gastroenterology, Ankara University School of Medicine, Ankara
Mehmet Ertem
Department of Pediatric Hematology, Ankara University Faculty of Medicine, Sıhhıye, Ankara, Turkey
Aydan Kansu
AÜTF Pediatrik Gastroenteroloji Bilim Dalı, Ankara
Hülya Çetinkaya
Departments of Gastroenterology Ankara University
Arzu Ensari
Departments of Gastroenterology Pathology Ankara University
Cite this Article
Kuş Öztürk, S., Kırmızı, A., Aras, N., Cansız Ersöz, C., Kurt Yüksel, M., Ünal İnce, E., … Ensari, A. (2023). Patterns and Grading of Gastrointestinal Graft-Versus-Host Disease: A Clinicopathologic Correlation Study. Turkish Journal of Gastroenterology, 34(5), 516–524. https://doi.org/10.5152/tjg.2023.22012
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