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Prepublished online as a Blood First Edition Paper on July 18, 2002; DOI 10.1182/blood-2002-03-0857. This Article Full Text Full Text (PDF) All Versions of this Article: 2002-03-0857v1 100/12/3903    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Rights and Permissions Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Akpek, G. Articles by Vogelsang, G. B. Search for Related Content PubMed PubMed Citation Articles by Akpek, G. Articles by Vogelsang, G. B. Related Collections Transplantation Clinical Trials and Observations Social Bookmarking                   What's this?  Previous Article  |  Table of Contents  |  Next Article  Blood, 1 December 2002, Vol. 100, No. 12, pp. 3903-3907 CLINICAL OBSERVATIONS, INTERVENTIONS, AND THERAPEUTIC TRIALS Hepatitic variant of graft-versus-host disease after donor lymphocyte infusion Görgün Akpek, John K. Boitnott, Linda A. Lee, Jason P. Hallick, Michael Torbenson, David A. Jacobsohn, Sally Arai, Viki Anders, and Georgia B. Vogelsang From the Department of Oncology, Pathology, and Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD. Graft-versus-host disease (GVHD) of the liver is characterized by bile duct damage and portal lymphocytic infiltrate. We report acute hepatitislike presentation of GVHD after donor lymphocyte infusion (DLI). Between April 1998 and September 2001, 73 patients received 94 DLI treatments. Liver GVHD developed after DLI in 22 (30%) patients whose median age was 43 years (range, 21 to 61 years). Onset of liver dysfunction was at 35 days (range, 11 to 406 days) after DLI. Fifteen patients underwent liver biopsy, and the diagnosis of liver GVHD was confirmed in 13 (87%) patients. After viral hepatitis and recent drug exposure were excluded, 11 (50%) patients were given a diagnosis of a hepatitic variant of GVHD based on histologic evidence of lobular hepatitis (n = 5), elevation of maximum serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST) level more than 10 times the upper normal limit (n = 9), or both. There was a significant difference in maximum ALT (P = .002) and AST (P = .01) level between the hepatitic-variant and classical GVHD groups. GVHD progressed in 14 (64%) patients, and 10 patients died after a median follow-up of 221 days (range, 31-1284 days). These observations suggest that GVHD that occurs after DLI may have distinct clinical features. Hepatitic-variant GVHD should be considered in the differential diagnosis in DLI recipients with unexplained hepatitis. © 2002 by The American Society of Hematology.   CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this? This article has been cited by other articles: C.-k. Hui, A. Lie, W.-y. Au, Y.-h. Leung, S.-y. Ma, W. W. W. Cheung, H.-y. Zhang, C.-s. Chim, Y.-l. Kwong, R. Liang, et al. A long-term follow-up study on hepatitis B surface antigen-positive patients undergoing allogeneic hematopoietic stem cell transplantation Blood, July 15, 2005; 106(2): 464 - 469. [Abstract] [Full Text] [PDF] G. Akpek, S. J. Lee, M. E. Flowers, S. Z. Pavletic, M. Arora, S. Lee, S. Piantadosi, K. A. Guthrie, J. C. Lynch, A. Takatu, et al. Performance of a new clinical grading system for chronic graft-versus-host disease: a multicenter study Blood, August 1, 2003; 102(3): 802 - 809. [Abstract] [Full Text] [PDF]

	Copyright © 2002 by American Society of Hematology         Online ISSN: 1528-0020