Background Human bone marrow transplantation (BMT) becomes an accepted treatment of leukemia, aplastic anemia, immunodeficiency syndromes, and hematologic malignancies. Colorectal surgeons must know how to determine and manage the main colonic complications.
Objective To review the clinical features, clinical and pathological staging of graft vs host disease (GVHD), and treatment of patients suffering with colonic complications of human bone marrow transplantation.
Patients and methods We have reviewed the records of all patients that received an allogeneic bone marrow transplant and were evaluated at our Colon and Rectal Surgery department due to gastrointestinal symptoms, between January 2007 and January 2012. The study was carried out in patients who developed colonic complications, all of them with clinical, histopathological or laboratory diagnosis.
Results The study group was constituted by 77 patients, 43 male and 34 female patients. We identified colonic complications in 30 patients (38.9%); five patients developed intestinal toxicity due to pretransplant chemotherapy (6.4%); graft vs. host disease was present in 16 patients (20%); 13 patients (16.8%) developed acute colonic GVHD, and 3 (3.8%) chronic GVHD. Infection was identified in 9 patients (11.6%).
Conclusions The three principal colonic complications are the chemotherapy toxicity, GVHD, and superinfection; the onset of symptoms could help to suspect the type of complication (0–20 day chemotherapy toxicity, 20 and more GVHD), and infection could appear in any time of transplantation.
MRI multi-spectral fat-water models assuming single or independent R2* for fat (R2*F) and water (R2*F) are non-invasive fat fraction (FF) quantification techniques, but there is no consensus on which is more accurate. Monte Carlo simulations allowed correlation of single R2*, R2*F, and R2*W with FF and assessment of the R2* models. MRI signal was synthesized by creating a virtual hepatic steatosis model from extracted characteristics of fat droplets (FD) obtained using histology. R2*W and single R2* were within the confidence bound of the in-vivo calibration and both R2* models predicted FF with high accuracy which confirms the suitability of Monte-Carlo model to mimic steatosis condition.
Chemical-shift based multi-spectral fat-water models accounting for single or dual R2* correction are used to assess hepatic iron concentration (HIC) and fat fraction (FF). In this study, we developed a Monte-Carlo based approach for simulating steatosis and iron overload models mimicking the in-vivo characteristics and synthesizing MRI signal to compare the accuracy of the R2* models to estimate FF in the presence of iron. Our results show that R2* estimated by single R2* model is highly governed by iron whereas dual R2* model predicts R2*-FF relationship close to the in-vivo calibration. Nevertheless, FF predicted by both the models were close to the true FF.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.