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Incidence, risk factors, and outcome of pneumatosis intestinalis in pediatric stem cell transplant recipients
Author(s) -
Korhonen Katrina,
Lovvorn Harold N.,
Koyama Tatsuki,
Koehler Elizabeth,
Calder Cassie,
Manes Becky,
Evans Misty,
Bruce Kathryn,
Ho Richard H.,
Domm Jennifer,
Frangoul Haydar
Publication year - 2012
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.23242
Subject(s) - medicine , incidence (geometry) , pneumatosis intestinalis , stem cell , outcome (game theory) , pediatrics , intensive care medicine , oncology , genetics , physics , optics , mathematics , mathematical economics , biology
Background Pneumatosis Intestinalis (PI) is a rare complication following hematopoietic stem cell transplant (HSCT). We sought to assess the incidence, risk factors, and outcome associated with PI. Procedure We retrospectively reviewed the incidence of PI among 178 patients who underwent allogeneic HSCT between September 1999 and February 2010. Results Eighteen of 178 children (10.1%) who received allogeneic HSCT developed PI at a median of 94 days (range, 11–1169) after transplant. All patients presented with either abdominal pain or distention, and half of the patients had free air on radiographs. Patients who developed PI had a significantly higher proportion of acute (83% vs. 44%, P = 0.002) and chronic graft versus host disease (GVHD; 56% vs. 18%, P < 0.001). Only 39% of patients with PI had GVHD involving the gasterointestinal track. All patients were managed conservatively without surgery. Transplant related mortality (TRM) was significantly higher in patients who developed PI compared to those who did not (OR 4.3, 95% CI: 1.3–13.1; P = 0.007), but no deaths were attributable to PI. Conclusions We conclude that PI is a common complication associated with treatment of GVHD after HSCT, and patients who develop PI experience higher TRM. Patients who develop PI should be managed medically. Pediatr Blood Cancer 2012; 58: 616–620. © 2011 Wiley Periodicals, Inc.