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Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is currently the most effective treatment option for hematological malignancies. Although supportive care for allo-HSCT has improved in recent years, graft-versus-host disease (GvHD) is still a severe, life threatening complication after transplantation. GvHD of the gastrointestinal tract (GI GvHD) can cause inferior mortality rates as well as worsen the patient’s systemic status, thus ensuring prompt diagnosis is mandatory.
To date, the optimal endoscopic approach is debated for GI GvHD patients, therefore Fady Daniel and colleagues compared the diagnostic yield of different anatomic site biopsies in the diagnosis of GI GvHD and evaluated the association between endoscopic findings and histopathology. The findings of this retrospective study were reported in Current Research in Translational Medicine.
Taken together, these results provide evidence that currently, the best endoscopic approach is the combination of upper endoscopy and flexible sigmoidoscopy with biopsies of normal and abnormal mucosa. The authors stated that “it should be emphasized that normal mucosa be biopsied especially in the duodenum and recto-sigmoid for a better diagnostic yield. All patients with suspected GI GvHD should be evaluated by endoscopy and tissue sampling.”
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